Provider Demographics
NPI:1598361529
Name:DIAZ LOZADA, ALEJANDRA (PHARMD)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:DIAZ LOZADA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S 23RD ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-3870
Mailing Address - Country:US
Mailing Address - Phone:910-695-5273
Mailing Address - Fax:
Practice Address - Street 1:2201 S COMMONS
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6023
Practice Address - Country:US
Practice Address - Phone:253-733-7521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-06
Last Update Date:2020-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61061595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist