Healthcare Provider Details

I. General information

NPI: 1619538683
Provider Name (Legal Business Name): GABRIELLA NICOLE ROMERO PA-C, MSPAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2019
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 COLBY AVE STE J
EVERETT WA
98201-4032
US

IV. Provider business mailing address

1728 W MARINE VIEW DR STE 110
EVERETT WA
98201-2094
US

V. Phone/Fax

Practice location:
  • Phone: 425-791-3093
  • Fax: 425-791-3094
Mailing address:
  • Phone: 425-791-3093
  • Fax: 425-791-3094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberPA60972448
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60972448
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: