Individual
MRS. GABRIELE M. LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1708 YAKIMA AVE, SUITE 105, TACOMA, WA 98405-5307
(253) 426-4420
(253) 426-4383
Mailing address
315 MARTIN LUTHER KING JR WAY, 3 PHILIP PAVILION, TACOMA, WA 98405-4234
(253) 403-2633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004845
WA
Other
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
Enumeration date
10/27/2006
Last updated
04/11/2017
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