Basic Information
| Provider Information | |||||||||
| NPI: | 1336652098 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AGUADO | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | GUADALUPE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1710 E FIR ST | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982732556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3609410197 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 125 N 18TH ST | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982733902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3608486616 | ||||||||
| FaxNumber: | 3605885565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2017 | ||||||||
| LastUpdateDate: | 11/15/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC1500X | RN60466786 | WA | Y | Nursing Service Providers | Registered Nurse | Community Health |
No ID Information.