Individual
LAURA LYNN AGUILAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
26458 MAPLE VALLEY BLACK DIAMOND RD SE, MAPLE VALLEY, WA 98038
(425) 690-3460
(425) 690-9460
Mailing address
3600 LIND AVE SW, SUITE 100 ATTN CREDENTIALING, RENTON, WA 98057
(425) 690-2715
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP60975529
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2143780
—
WA
Enumeration date
06/14/2016
Last updated
05/05/2021
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