Provider Demographics
NPI:1205646247
Name:GONZALEZ, AUDRIANA (NTP, RWP, CNC, CPT)
Entity type:Individual
Prefix:
First Name:AUDRIANA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:NTP, RWP, CNC, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1148 NW 59TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-2916
Mailing Address - Country:US
Mailing Address - Phone:206-605-9181
Mailing Address - Fax:
Practice Address - Street 1:1148 NW 59TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-2916
Practice Address - Country:US
Practice Address - Phone:206-605-9181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA256426246Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology