Provider Demographics
NPI:1124266184
Name:GUZMAN AGUAYO, NELIO (MD)
Entity type:Individual
Prefix:DR
First Name:NELIO
Middle Name:
Last Name:GUZMAN AGUAYO
Suffix:
Gender:M
Credentials:MD
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 421
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0421
Mailing Address - Country:US
Mailing Address - Phone:509-474-2072
Mailing Address - Fax:
Practice Address - Street 1:105 W 8TH AVE
Practice Address - Street 2:SUITE 7060
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2302
Practice Address - Country:US
Practice Address - Phone:509-747-2054
Practice Address - Fax:509-747-2054
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-29
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0396207RN0300X, 2080P0210X
WAMD603214392080P0210X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology