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NPI Code Detail

MEDICARE: ELEAZAR JR. AGUILERA-REYES

MEDICARE: ELEAZAR JR. AGUILERA-REYES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1649134651
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELEAZAR JR. AGUILERA-REYES
Provider Business Mailing Address
First Line : 1525 SW SHIRLEY ANN DR
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-7665
Country : US
Telephone Number : 503-472-9603
Fax Number :
Provider Business Practice Location Address
First Line : 1525 SW SHIRLEY ANN DR
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-7665
Country : US
Telephone Number : 503-472-9603
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2025
Last Update Date : 12/20/2025

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Directions to “ ELEAZAR JR. AGUILERA-REYES ” Practice Location

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