Individual
DEREK A GALLICHOTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 9TH AVE, MS M4-PA, SEATTLE, WA 98101-2756
(206) 583-6025
(206) 515-5886
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10001366
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039594
LABOR AND INDUSTRIES #
WA
05
—
8329294
—
WA
01
—
970001476
RAILROAD MC#
WA
01
—
GA0072
BLUE SHIELD #
WA
01
—
US2023376
AETNA SPECIALIST PIN
WA
Enumeration date
01/15/2007
Last updated
06/17/2008
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