Provider Demographics
NPI:1386079515
Name:AURILIO, DANELLE MARIA (LM AND LMT)
Entity type:Individual
Prefix:
First Name:DANELLE
Middle Name:MARIA
Last Name:AURILIO
Suffix:
Gender:F
Credentials:LM AND LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 W BENTON ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:WA
Mailing Address - Zip Code:98826-1003
Mailing Address - Country:US
Mailing Address - Phone:360-473-9716
Mailing Address - Fax:
Practice Address - Street 1:310 S MISSION ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3044
Practice Address - Country:US
Practice Address - Phone:509-663-2770
Practice Address - Fax:509-665-3869
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA225700000X
WAMW60384679176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2049266Medicaid