Individual
MS. GAYLE LYNN FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
141 LILLY RD NE, OLYMPIA, WA 98506-5028
(360) 413-8880
(360) 810-3697
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60255470
WA
363AM0700X
Medical Physician Assistant
PA60255470
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114167830
—
WA
Enumeration date
02/21/2009
Last updated
05/09/2025
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