Provider Demographics
NPI:1225484306
Name:AIELLO, AILEEN T (MS)
Entity Type:Individual
Prefix:MS
First Name:AILEEN
Middle Name:T
Last Name:AIELLO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ALYX
Other - Middle Name:
Other - Last Name:AIELLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6613 NE GRAND AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-4680
Mailing Address - Country:US
Mailing Address - Phone:503-752-0401
Mailing Address - Fax:
Practice Address - Street 1:10000 NE 7TH AVE STE 403
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-4548
Practice Address - Country:US
Practice Address - Phone:360-952-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60994391101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor