Provider Demographics
NPI:1104608991
Name:D'AMELIO, GABRIELLA SHEA (RN)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:SHEA
Last Name:D'AMELIO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GABI
Other - Middle Name:
Other - Last Name:DAMELIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:205 MOUNTAIN LOOP HWY
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:98252
Mailing Address - Country:US
Mailing Address - Phone:360-348-0544
Mailing Address - Fax:
Practice Address - Street 1:205 MOUNTAIN LOOP HWY
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:WA
Practice Address - Zip Code:98252
Practice Address - Country:US
Practice Address - Phone:360-348-0544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61481010163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool