Provider Demographics
NPI:1023360450
Name:SWISHER, GABRIELLE S (BA, QMHA)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:S
Last Name:SWISHER
Suffix:
Gender:F
Credentials:BA, QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4585 SW 185TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-1557
Mailing Address - Country:US
Mailing Address - Phone:207-837-0546
Mailing Address - Fax:
Practice Address - Street 1:4585 SW 185TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-1557
Practice Address - Country:US
Practice Address - Phone:207-837-0546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist