Provider Demographics
NPI:1477594539
Name:GABRIEL, TERI LYN (DC)
Entity Type:Individual
Prefix:DR
First Name:TERI LYN
Middle Name:
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1748 NW FAIVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-3842
Mailing Address - Country:US
Mailing Address - Phone:503-492-3910
Mailing Address - Fax:503-674-6706
Practice Address - Street 1:1748 NW FAIVIEW DR
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3842
Practice Address - Country:US
Practice Address - Phone:503-492-3910
Practice Address - Fax:503-674-6706
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3601111N00000X
WACH00034518111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8856626Medicare ID - Type Unspecified