Provider Demographics
NPI:1619587334
Name:DE LA O, ARACELI (CMI)
Entity Type:Individual
Prefix:
First Name:ARACELI
Middle Name:
Last Name:DE LA O
Suffix:
Gender:F
Credentials:CMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35426 25TH AVE SW APT 9-201
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-3352
Mailing Address - Country:US
Mailing Address - Phone:253-442-3074
Mailing Address - Fax:
Practice Address - Street 1:35426 25TH AVE SW APT 9-201
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-3352
Practice Address - Country:US
Practice Address - Phone:253-442-3074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11927171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter