Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | MD60321439 | WA |
N | 207RN0300X | Nephrologist | P0396 | TX |
N | 2080P0210X | Pediatric Nephrologist | MD60321439 | WA |
N | 2080P0210X | Pediatric Nephrologist | P0396 | TX |
NPI | 1124266184 |
---|---|
Provider Name | Dr. Nelio Guzman Aguayo |
First Address | Liberty Lake, WA 99019-0421 |
Second Address | Spokane, WA 99204-2302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2009 |
Last Update Date | 25/05/2021 |