Provider Demographics
NPI:1093988248
Name:DEACONU, GABRIELA (NAC)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:DEACONU
Suffix:
Gender:F
Credentials:NAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 177TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-3408
Mailing Address - Country:US
Mailing Address - Phone:425-641-4603
Mailing Address - Fax:425-641-4603
Practice Address - Street 1:931 177TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-3408
Practice Address - Country:US
Practice Address - Phone:425-641-4603
Practice Address - Fax:425-641-4603
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA295201311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home