Provider Demographics
NPI:1063761641
Name:ANGUIANO, ANGELICA MARIA
Entity type:Individual
Prefix:MS
First Name:ANGELICA
Middle Name:MARIA
Last Name:ANGUIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 W CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3269
Mailing Address - Country:US
Mailing Address - Phone:509-930-2085
Mailing Address - Fax:
Practice Address - Street 1:4305 W CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3269
Practice Address - Country:US
Practice Address - Phone:509-930-2085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA973798171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA983868OtherSTATE CERTIFIED SOCIAL INTERPRETER
WA973798OtherSTATE CERTIFIED MEDICAL INTERPRETER