Provider Demographics
NPI:1457087132
Name:JONES, GABRIEL TAYLOR
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:TAYLOR
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13004 SE 151ST ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-2893
Mailing Address - Country:US
Mailing Address - Phone:407-840-4821
Mailing Address - Fax:
Practice Address - Street 1:13004 SE 151ST ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-2893
Practice Address - Country:US
Practice Address - Phone:407-840-4821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician