Provider Demographics
NPI:1184234122
Name:PINO, AURELIO
Entity type:Individual
Prefix:
First Name:AURELIO
Middle Name:
Last Name:PINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8008 S 114TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-3242
Mailing Address - Country:US
Mailing Address - Phone:206-383-4516
Mailing Address - Fax:
Practice Address - Street 1:8008 S 114TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-3242
Practice Address - Country:US
Practice Address - Phone:206-383-4516
Practice Address - Fax:206-826-1397
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC5829171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter