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NPI Code Detail

MEDICARE: GABRIELA MCTYIER O.D.

MEDICARE:   GABRIELA  MCTYIER  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist3148ATOR
2152W00000XOptometrist4026WA

General Provider Information

NPI Number : 1437136611
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIELA MCTYIER O.D.
Provider Business Mailing Address
First Line : 14406 NE 20TH AVE
Second Line :
City : VANCOUVER
State : WA
Zip : 98686-1448
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14406 NE 20TH AVE
Second Line :
City : VANCOUVER
State : WA
Zip : 98686-1448
Country : US
Telephone Number : 360-571-3084
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 02/14/2022

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Directions to “ GABRIELA MCTYIER O.D.” Practice Location

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