Healthcare Provider Details

I. General information

NPI: 1437859493
Provider Name (Legal Business Name): TATIANA ASPILLAGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 03/08/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 COLLINGTREE ST
LAS VEGAS NV
89145-8513
US

IV. Provider business mailing address

1033 COLLINGTREE ST
LAS VEGAS NV
89145-8513
US

V. Phone/Fax

Practice location:
  • Phone: 503-720-2088
  • Fax:
Mailing address:
  • Phone: 503-720-2088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberB01971
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: