Individual
DENISE J GRUCHALLA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3908 10TH ST SE, PUYALLUP, WA 98374-2188
(253) 848-5951
(253) 864-8954
Mailing address
3908 10TH ST SE, PUYALLUP, WA 98374-2188
(253) 848-5951
(253) 864-8954
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10003351
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0200220
LABOR AND INDUSTRIES
WA
01
—
2732GR
REGENCE RIDER
WA
05
—
8416265
—
WA
01
—
8906995
LABOR AND INDUSTRIES VOC
WA
Enumeration date
06/04/2006
Last updated
07/08/2007
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