Provider Demographics
NPI:1356083935
Name:ASPREC, ROYALLE-ASHLEY AZURIN I
Entity Type:Individual
Prefix:
First Name:ROYALLE-ASHLEY
Middle Name:AZURIN
Last Name:ASPREC
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5907 NE 102ND AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6319
Mailing Address - Country:US
Mailing Address - Phone:360-213-4962
Mailing Address - Fax:
Practice Address - Street 1:738 NE DAVIS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2931
Practice Address - Country:US
Practice Address - Phone:503-462-5603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker