Healthcare Provider Details

I. General information

NPI: 1154007722
Provider Name (Legal Business Name): GABRIELLE MADISON PARLI PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

3938 1ST AVE NE UNIT A
SEATTLE WA
98105-6803
US

V. Phone/Fax

Practice location:
  • Phone: 206-277-1746
  • Fax:
Mailing address:
  • Phone: 303-808-9696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberI10301
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP10852
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: