Provider Demographics
NPI:1003529264
Name:WOOD-BIANCHI, GABRIEL (LMT)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:WOOD-BIANCHI
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12800 SE 7TH ST APT P4
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-4029
Mailing Address - Country:US
Mailing Address - Phone:415-430-8428
Mailing Address - Fax:
Practice Address - Street 1:12800 SE 7TH ST APT P4
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-4029
Practice Address - Country:US
Practice Address - Phone:415-430-8428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61389028225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist