Individual
GABLE HARVEY LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
710 SE CHINOOK DR APT K50, PULLMAN, WA 99163-4822
(360) 490-6369
Mailing address
560 W SIMPSON RD, SHELTON, WA 98584-8082
(360) 490-6369
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/15/2019
Last updated
04/15/2019
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