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Individual

MS. KAREN A AGUILERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
4212 SE HULL AVE, PORTLAND, OR 97267-6443
(503) 449-2695
Mailing address
PO BOX 68696, PORTLAND, OR 97268-0696
(503) 449-2695

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11632
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
158286
OR
01
838353004
BLUE CROSS PROVIDER NUMBE
OR
Enumeration date
01/24/2007
Last updated
08/12/2014
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