Provider Demographics
NPI:1467785618
Name:SALAS, GABRIELA (MEDICAL ASSISTANT)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:SALAS
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 S MILLER DR
Mailing Address - Street 2:104
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-2745
Mailing Address - Country:US
Mailing Address - Phone:720-329-1762
Mailing Address - Fax:
Practice Address - Street 1:2626 S MILLER DR
Practice Address - Street 2:104
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-2745
Practice Address - Country:US
Practice Address - Phone:720-329-1762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO163W00000X163W00000X
CO164W00000X164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse