Provider Demographics
NPI:1245659838
Name:D'JAEN, GABRIELA ANDREA (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:ANDREA
Last Name:D'JAEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 OLIVE WAY STE 204
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1726
Mailing Address - Country:US
Mailing Address - Phone:206-329-5255
Mailing Address - Fax:206-208-9939
Practice Address - Street 1:509 OLIVE WAY STE 204
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1726
Practice Address - Country:US
Practice Address - Phone:206-329-5255
Practice Address - Fax:206-208-9939
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1401402084P0800X
WAMD608407662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD60840766OtherWA LICENSE