Healthcare Provider Details

I. General information

NPI: 1225958002
Provider Name (Legal Business Name): GABRIELLE MIELKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 BOYER AVE E
SEATTLE WA
98112-2922
US

IV. Provider business mailing address

1850 BOYER AVE E
SEATTLE WA
98112-2922
US

V. Phone/Fax

Practice location:
  • Phone: 206-325-8477
  • Fax: 206-325-8477
Mailing address:
  • Phone: 206-325-8477
  • Fax: 206-325-8477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: