Provider Demographics
NPI:1104997782
Name:AGUILO, NEIL SOLSONA (DC)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:SOLSONA
Last Name:AGUILO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1628
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-0157
Mailing Address - Country:US
Mailing Address - Phone:360-917-5192
Mailing Address - Fax:
Practice Address - Street 1:3100 SE MILE HILL DR
Practice Address - Street 2:SUITE A
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-2962
Practice Address - Country:US
Practice Address - Phone:360-895-4844
Practice Address - Fax:360-895-4834
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA193876OtherL&I PROVIDER #
WACH00034429OtherSTATE CHIROPRACTIC LICENS