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1326139700 NPI number — MARIEL CASTILLO MD

NPI Number: 1326139700
Health Care Provider/Practitioner: MARIEL CASTILLO MD

Information about “1326139700” NPI (MARIEL CASTILLO MD) exists in 1326139700 in HTML format HTML  |  1326139700 in plain Text format TXT  |  1326139700 in PDF (Portable Document Format) PDF  |  1326139700 in an XML format XML  formats.

NPI Number : 1326139700 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1326139700",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CASTILLO",
    "FirstName": "MARIEL",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CASTILLO-GUANZON",
    "OtherFirstName": "MARIEL",
    "OtherMiddleName": null,
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1400 E. KINCAID STREET",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MOUNT VERNON",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98274-4127",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "360-428-2500",
    "MailingAddressFaxNumber": "360-428-6485",
    "FirstLinePracticeLocationAddress": "2320 FREEWAY DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MOUNT VERNON",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98273-5445",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "360-814-6870",
    "PracticeLocationAddressFaxNumber": "360-814-6871",
    "EnumerationDate": "09/28/2006",
    "LastUpdateDate": "03/29/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "208000000X",
        "TaxonomyName": "Pediatrics Physician",
        "LicenseNumber": "MD60091777",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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