Provider Demographics
NPI:1619547445
Name:ZANSBERG, GABRIEL W
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:W
Last Name:ZANSBERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 14TH AVE APT D
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4596
Mailing Address - Country:US
Mailing Address - Phone:720-771-9775
Mailing Address - Fax:
Practice Address - Street 1:6112 GOULD AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-2959
Practice Address - Country:US
Practice Address - Phone:206-930-2438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst