Healthcare Provider Details

I. General information

NPI: 1629913686
Provider Name (Legal Business Name): ROLIZA CELESTINO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32524 35TH AVE SW
FEDERAL WAY WA
98023-2666
US

IV. Provider business mailing address

32524 35TH AVE SW
FEDERAL WAY WA
98023-2666
US

V. Phone/Fax

Practice location:
  • Phone: 253-318-8963
  • Fax:
Mailing address:
  • Phone: 253-318-8963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number754787
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: