Provider Demographics
NPI:1508143496
Name:GADALA MARIA, VICTORIA
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:GADALA MARIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GAUDALUPE
Other - Middle Name:
Other - Last Name:VICTORIA SCHMITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:206-764-3335
Mailing Address - Fax:206-764-0489
Practice Address - Street 1:12835 BEL RED RD
Practice Address - Street 2:BLDG 100 SUITE 145
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2631
Practice Address - Country:US
Practice Address - Phone:425-460-7114
Practice Address - Fax:425-460-7115
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60256575101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor