Provider Demographics
NPI:1245379312
Name:ANGUIANO, GABRIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:ANGUIANO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 W CANAL DR
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1402
Mailing Address - Country:US
Mailing Address - Phone:509-783-5500
Mailing Address - Fax:509-735-3558
Practice Address - Street 1:5221 W CANAL DR
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1402
Practice Address - Country:US
Practice Address - Phone:509-783-5500
Practice Address - Fax:509-735-3558
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002745111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor