Healthcare Provider Details

I. General information

NPI: 1528445889
Provider Name (Legal Business Name): JOSHUA ADDISON GABEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 A JACKSON AVE
TACOMA WA
98431-9210
US

IV. Provider business mailing address

8550 W CHARLESTON BLVD STE 102-401
LAS VEGAS NV
89117-9210
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-3104
  • Fax:
Mailing address:
  • Phone: 775-343-9275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD61490660
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: