Provider Demographics
NPI:1871334086
Name:PENALOZA RAMIREZ, ALEJANDRA GABRIELA
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:GABRIELA
Last Name:PENALOZA RAMIREZ
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 1:2822 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-3178
Mailing Address - Country:US
Mailing Address - Phone:971-322-8237
Mailing Address - Fax:
Practice Address - Street 1:2822 14TH AVE
Practice Address - Street 2:
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-3178
Practice Address - Country:US
Practice Address - Phone:971-322-8237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula