Individual
MARLENE DIAZ AGUILAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1312 E POWELL BLVD, GRESHAM, OR 97030-8003
(971) 427-4222
Mailing address
6200 SE KING RD, PORTLAND, OR 97222-2891
(971) 427-4222
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
112843
OR
Other
Enumeration date
12/18/2024
Last updated
12/18/2024
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