Provider Demographics
NPI:1710852553
Name:GAMARRA, RICHARD (THERAPIST)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:GAMARRA
Suffix:
Gender:M
Credentials:THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3313 CAMPBELL DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-1107
Mailing Address - Country:US
Mailing Address - Phone:703-261-9611
Mailing Address - Fax:
Practice Address - Street 1:4810 BEAUREGARD ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-1737
Practice Address - Country:US
Practice Address - Phone:703-261-9611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty