Provider Demographics
NPI:1427389204
Name:SY, AILEEN CECILLE DU ALO
Entity Type:Individual
Prefix:MISS
First Name:AILEEN CECILLE
Middle Name:DU ALO
Last Name:SY
Suffix:
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 1:1609 SE 92ND CT
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-2860
Mailing Address - Country:US
Mailing Address - Phone:360-737-1527
Mailing Address - Fax:360-694-8613
Practice Address - Street 1:1609 SE 92ND CT
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-2860
Practice Address - Country:US
Practice Address - Phone:360-737-7527
Practice Address - Fax:360-694-8613
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR237104225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist