Provider Demographics
NPI:1669188751
Name:GONZALEZ AGUILAR, JOCELYN D
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:D
Last Name:GONZALEZ AGUILAR
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 1:8020 169TH AVE NE APT 8
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3963
Mailing Address - Country:US
Mailing Address - Phone:509-930-1390
Mailing Address - Fax:
Practice Address - Street 1:8020 169TH AVE NE APT 8
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3963
Practice Address - Country:US
Practice Address - Phone:509-930-1390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter