Individual
NICO AGUILAR SHANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12655 SW CENTER ST STE 100, BEAVERTON, OR 97005-1600
(503) 828-3402
Mailing address
7915 N HEREFORD AVE, PORTLAND, OR 97203-3437
(971) 645-5279
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
A14715
OR
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/26/2021
Last updated
01/25/2025
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