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Individual
GALE C TINKER
Active
Individual
GALE C TINKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA219
ID
363A00000X
Physician Assistant
Primary
PA642
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010136926
REGENCE BLUE SHIELD OF ID
ID
01
—
PASG4
BLUE CROSS OF ID
ID
Enumeration date
08/16/2005
Last updated
04/08/2008
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