Provider Demographics
NPI:1578391249
Name:AGUILAR, GRETCHEN RENEE (ARNP, FNP-C)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:RENEE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:MALOTT
Mailing Address - State:WA
Mailing Address - Zip Code:98829-0084
Mailing Address - Country:US
Mailing Address - Phone:509-429-2254
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 84
Practice Address - Street 2:
Practice Address - City:MALOTT
Practice Address - State:WA
Practice Address - Zip Code:98829-0084
Practice Address - Country:US
Practice Address - Phone:509-429-2254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61589138363LA2100X, 363LS0200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool