Provider Demographics
NPI:1992182976
Name:REBUTIACO, AIMEE CAMARA (COTA/L)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:CAMARA
Last Name:REBUTIACO
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 PIKE ST NE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4629
Mailing Address - Country:US
Mailing Address - Phone:206-992-1926
Mailing Address - Fax:
Practice Address - Street 1:525 PIKE ST NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4629
Practice Address - Country:US
Practice Address - Phone:206-992-1926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60303308172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker