Provider Demographics
NPI:1598825903
Name:TORRES, GABRIEL (DC)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:TORRES
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 1:4004 NE 4TH ST
Mailing Address - Street 2:SUITE # 107-209
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-4102
Mailing Address - Country:US
Mailing Address - Phone:253-579-6105
Mailing Address - Fax:253-449-0510
Practice Address - Street 1:11210 BRIDGEPORT WAY SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3003
Practice Address - Country:US
Practice Address - Phone:253-579-6105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor