Provider Demographics
NPI:1093138364
Name:ARAGON, DAMARIS (AP60440429)
Entity Type:Individual
Prefix:
First Name:DAMARIS
Middle Name:
Last Name:ARAGON
Suffix:
Gender:F
Credentials:AP60440429
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 W FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6834
Mailing Address - Country:US
Mailing Address - Phone:509-342-6592
Mailing Address - Fax:509-318-2020
Practice Address - Street 1:400 S JEFFERSON ST STE 204
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-3142
Practice Address - Country:US
Practice Address - Phone:509-342-6592
Practice Address - Fax:509-318-2020
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-22
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60440429163WP0809X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult