Provider Demographics
NPI:1508140872
Name:CUTZ, AILEEN (BSW)
Entity Type:Individual
Prefix:MRS
First Name:AILEEN
Middle Name:
Last Name:CUTZ
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 MOYER LN NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-3822
Mailing Address - Country:US
Mailing Address - Phone:503-370-8990
Mailing Address - Fax:
Practice Address - Street 1:290 MOYER LN NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-3822
Practice Address - Country:US
Practice Address - Phone:503-370-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9888994171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator