Provider Demographics
NPI:1093167025
Name:OGABI, GLORIA (MD)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:OGABI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26730 196TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-6006
Mailing Address - Country:US
Mailing Address - Phone:425-777-6374
Mailing Address - Fax:
Practice Address - Street 1:1300 N 1ST ST
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-1702
Practice Address - Country:US
Practice Address - Phone:509-248-4510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMDCE.ML.61570332207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine