Provider Demographics
NPI:1609108406
Name:GIEBELS, VERENA MARIA (LMP)
Entity Type:Individual
Prefix:
First Name:VERENA
Middle Name:MARIA
Last Name:GIEBELS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310A OYSTER CREEK LN
Mailing Address - Street 2:
Mailing Address - City:BOW
Mailing Address - State:WA
Mailing Address - Zip Code:98232-8571
Mailing Address - Country:US
Mailing Address - Phone:360-421-9816
Mailing Address - Fax:
Practice Address - Street 1:1330 S 2ND ST STE 103
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-4804
Practice Address - Country:US
Practice Address - Phone:360-421-6296
Practice Address - Fax:360-991-0017
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60058669225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist