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Individual
DR. GABRIEL STEPHAN NILES
Active
Individual
DR. GABRIEL STEPHAN NILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A100831
CA
207Q00000X
Family Medicine Physician
MD6030955
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2045010
WA MEDICAID PROVIDER ID
WA
01
—
G8940666
MEDICARE PTAN
WA
Enumeration date
12/28/2005
Last updated
11/28/2022
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