Provider Demographics
NPI:1336652098
Name:AGUADO, MARIA GUADALUPE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:GUADALUPE
Last Name:AGUADO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 E FIR ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-2556
Mailing Address - Country:US
Mailing Address - Phone:360-941-0197
Mailing Address - Fax:
Practice Address - Street 1:125 N 18TH ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-3902
Practice Address - Country:US
Practice Address - Phone:360-848-6616
Practice Address - Fax:360-588-5565
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60466786163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health