Provider Demographics
NPI:1427159912
Name:ROSENBERG, GAIL (PHD)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11411 NE 124TH ST
Mailing Address - Street 2:SUITE 190
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-4314
Mailing Address - Country:US
Mailing Address - Phone:425-821-2121
Mailing Address - Fax:425-823-8235
Practice Address - Street 1:11411 NE 124TH ST
Practice Address - Street 2:SUITE 190
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4314
Practice Address - Country:US
Practice Address - Phone:425-821-2121
Practice Address - Fax:425-823-8235
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA728103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist