Provider Demographics
NPI:1760926869
Name:PRICE, GABRIELLA CAITLIN (LM, CPM)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:CAITLIN
Last Name:PRICE
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4416
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-0042
Mailing Address - Country:US
Mailing Address - Phone:425-405-0278
Mailing Address - Fax:425-332-7026
Practice Address - Street 1:5131 COLBY AVE STE B
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-3355
Practice Address - Country:US
Practice Address - Phone:425-405-0278
Practice Address - Fax:425-332-7026
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60741161OtherMIDWIFE LICENSE
WA2081353Medicaid