Healthcare Provider Details

I. General information

NPI: 1568266500
Provider Name (Legal Business Name): ABIGAIL MONTES-GASGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8615 14TH AVE S
SEATTLE WA
98108-4806
US

IV. Provider business mailing address

13256 8TH AVE S
BURIEN WA
98168-2720
US

V. Phone/Fax

Practice location:
  • Phone: 206-461-4880
  • Fax:
Mailing address:
  • Phone: 206-355-5133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number61595597
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: