Provider Demographics
NPI:1851922827
Name:ZARA, AILEEN JOYCE G
Entity Type:Individual
Prefix:
First Name:AILEEN JOYCE
Middle Name:G
Last Name:ZARA
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 1:3904 SE CESAR E CHAVEZ BLVD APT 11
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-3175
Mailing Address - Country:US
Mailing Address - Phone:707-210-6721
Mailing Address - Fax:
Practice Address - Street 1:3904 SE CESAR E CHAVEZ BLVD APT 11
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-3175
Practice Address - Country:US
Practice Address - Phone:707-210-6721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula