Healthcare Provider Details

I. General information

NPI: 1174448575
Provider Name (Legal Business Name): LUIS ROJAS CELIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4916 CENTER ST STE G
TACOMA WA
98409-2348
US

IV. Provider business mailing address

1345 OLD COUNTY RD
BELMONT CA
94002-3922
US

V. Phone/Fax

Practice location:
  • Phone: 206-429-5260
  • Fax:
Mailing address:
  • Phone: 650-701-4964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: