Individual
GABRIELLE DIONYSE LAUREN BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1205 N 10TH ST STE A, RENTON, WA 98057-5577
(425) 690-3475
(425) 690-9475
Mailing address
3600 LIND AVE SW, SUITE 100 ATTN CREDENTIALING, RENTON, WA 98057-4970
(425) 690-2715
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G85928
CA
207P00000X
Emergency Medicine Physician
Primary
MD60862290
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G859280
BLUE SHIELD
CA
05
—
00G859280
—
CA
01
—
050126CG35107
VALLEY PRES TRAILBLAZER
CA
05
—
2106688
—
WA
01
—
930123114
VALLEY PRES RAILROAD
CA
01
—
G85928
BLUE CROSS
CA
Enumeration date
05/26/2006
Last updated
08/17/2021
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