Provider Demographics
NPI:1932706330
Name:ARREOLA, AMELIA NOEMI (MC)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:NOEMI
Last Name:ARREOLA
Suffix:
Gender:F
Credentials:MC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W 5TH ST TRLR 77
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930-1291
Mailing Address - Country:US
Mailing Address - Phone:509-831-3266
Mailing Address - Fax:
Practice Address - Street 1:400 W 5TH ST TRLR 77
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930-1291
Practice Address - Country:US
Practice Address - Phone:509-831-3266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC55778171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter