Basic Information
| Provider Information | |||||||||
| NPI: | 1841338571 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GABEL | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 S SCHEUBER RD | ||||||||
| Address2: | |||||||||
| City: | CENTRALIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985318877 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603308950 | ||||||||
| FaxNumber: | 3603308955 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 S SCHEUBER RD | ||||||||
| Address2: | |||||||||
| City: | CENTRALIA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985318877 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603308950 | ||||||||
| FaxNumber: | 3603308955 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2007 | ||||||||
| LastUpdateDate: | 03/03/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | OP00001434 | WA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | AB23193 | 01 | WA | MEDICARE GROUP | OTHER | 1108349 | 05 | WA | MEDICAID |