Provider Demographics
NPI:1689703944
Name:GUARRIELLO, AIMEE CATHERINE (PT, OCS, CSCS)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:CATHERINE
Last Name:GUARRIELLO
Suffix:
Gender:F
Credentials:PT, OCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 SE YUKON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5318
Mailing Address - Country:US
Mailing Address - Phone:503-753-5639
Mailing Address - Fax:503-230-1745
Practice Address - Street 1:1610 SE GLENWOOD ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-5615
Practice Address - Country:US
Practice Address - Phone:503-230-1744
Practice Address - Fax:503-230-1745
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4508225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist