Provider Demographics
NPI:1902274053
Name:KULHANEK-ARENAS, GABRIEL PETER (LMP)
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:PETER
Last Name:KULHANEK-ARENAS
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:MR
Other - First Name:GABRIEL
Other - Middle Name:PETER
Other - Last Name:ARENAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:3003 S PERRY ST
Mailing Address - Street 2:APT 76
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3978
Mailing Address - Country:US
Mailing Address - Phone:206-713-2351
Mailing Address - Fax:
Practice Address - Street 1:12 E ROWAN AVE
Practice Address - Street 2:SUITE L5
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-6007
Practice Address - Country:US
Practice Address - Phone:206-713-2351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-07
Last Update Date:2015-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60407849225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist