Healthcare Provider Details

I. General information

NPI: 1316851967
Provider Name (Legal Business Name): NAELEA MENDOZA AGUILAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 SW 3RD AVE STE 200
PORTLAND OR
97204-2507
US

IV. Provider business mailing address

625 NE ASPEN DR
HERMISTON OR
97838-1414
US

V. Phone/Fax

Practice location:
  • Phone: 503-438-4464
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: