Provider Demographics
NPI:1730377995
Name:JUGUILON, CRISPIN LAMADRIO JR (MD)
Entity type:Individual
Prefix:DR
First Name:CRISPIN
Middle Name:LAMADRIO
Last Name:JUGUILON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:135 SE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-2203
Mailing Address - Country:US
Mailing Address - Phone:541-278-2222
Mailing Address - Fax:541-276-8405
Practice Address - Street 1:135 SE 1ST ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-2203
Practice Address - Country:US
Practice Address - Phone:541-278-2222
Practice Address - Fax:541-276-8405
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD214292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry