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Individual

LISA MARIE GAIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
10004 204TH AVE E, # 1200, 3400, BONNEY LAKE, WA 98391-6539
(253) 848-5951
(253) 845-7073
Mailing address
3908 10TH ST SE, PUYALLUP, WA 98374-2188
(253) 848-5951
(253) 845-7073

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60729786
WA

Other

Enumeration date
10/07/2011
Last updated
05/08/2017
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