Provider Demographics
NPI:1467118323
Name:AGUILAR, GEORGIANNA LYNN
Entity Type:Individual
Prefix:
First Name:GEORGIANNA
Middle Name:LYNN
Last Name:AGUILAR
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 1:795 24TH AVE SE APT 4
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-4242
Mailing Address - Country:US
Mailing Address - Phone:541-777-3070
Mailing Address - Fax:
Practice Address - Street 1:795 24TH AVE SE APT 4
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-4242
Practice Address - Country:US
Practice Address - Phone:541-777-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist