Provider Demographics
NPI:1235363771
Name:ARISTI, MAGALI M
Entity Type:Individual
Prefix:MRS
First Name:MAGALI
Middle Name:M
Last Name:ARISTI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MAGALI
Other - Middle Name:M
Other - Last Name:ARISTI-DUARTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2710 MAGONE LN
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-2442
Mailing Address - Country:US
Mailing Address - Phone:503-657-5277
Mailing Address - Fax:
Practice Address - Street 1:2710 MAGONE LN
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-2442
Practice Address - Country:US
Practice Address - Phone:503-657-5277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4453172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker