Provider Demographics
NPI:1366706012
Name:BASSIN, GABRIELLE (DVM)
Entity type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:
Last Name:BASSIN
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14810 15TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155-7126
Mailing Address - Country:US
Mailing Address - Phone:206-204-3366
Mailing Address - Fax:
Practice Address - Street 1:14810 15TH AVE NE
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-7126
Practice Address - Country:US
Practice Address - Phone:204-206-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVT 60269832174M00000X
CA18524174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian