# MRS. GABRIELE M. LALLY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1467538223
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10004845 | WA | Yes |

## Other

- **Enumeration date:** 10/27/2006
- **Last updated:** 04/11/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0259143 | STATE L&I | WA |
| 01 | — | 20110221364696 | STATE L&I | WA |
| 01 | — | 335060 | INTERNAL ID-MOTOR VEHICLE ID | — |
| 05 | — | 8431595 | — | WA |