Provider Demographics
NPI:1316728322
Name:AGUIRRE MONDAY, ANA K (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:K
Last Name:AGUIRRE MONDAY
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
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 336
Mailing Address - Street 2:
Mailing Address - City:OTHELLO
Mailing Address - State:WA
Mailing Address - Zip Code:99344-0336
Mailing Address - Country:US
Mailing Address - Phone:509-331-6404
Mailing Address - Fax:
Practice Address - Street 1:25 S 7TH AVE
Practice Address - Street 2:
Practice Address - City:OTHELLO
Practice Address - State:WA
Practice Address - Zip Code:99344-1401
Practice Address - Country:US
Practice Address - Phone:509-770-4067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61228299225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist