Individual
MELISSA L GAMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1802 S UNION AVE, SUITE 200, TACOMA, WA 98405
(253) 752-6965
(253) 759-6056
Mailing address
4800 COLLEGE ST SE, PMG SW WA LACEY FM, LACEY, WA 98503
(360) 486-2900
(360) 486-2901
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004887
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0207064
LABOR & INDUSTRIES
WA
01
—
1820GA
REGENEE BC BS
WA
05
—
8448573
—
WA
Enumeration date
08/10/2006
Last updated
01/05/2017
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