Healthcare Provider Details

I. General information

NPI: 1407906472
Provider Name (Legal Business Name): GABRIELA ESTRADA VELAZQUEZ LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16259 SYLVESTER RD SW STE 102
BURIEN WA
98166-3094
US

IV. Provider business mailing address

2421 SW TRENTON ST APT 206
SEATTLE WA
98106-2285
US

V. Phone/Fax

Practice location:
  • Phone: 206-242-5186
  • Fax: 206-971-1986
Mailing address:
  • Phone: 206-607-7154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00016898
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: