Provider Demographics
NPI:1184669525
Name:GALE, DEBBRA M (ARNP-C, MSN)
Entity Type:Individual
Prefix:
First Name:DEBBRA
Middle Name:M
Last Name:GALE
Suffix:
Gender:F
Credentials:ARNP-C, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NE MOTHER JOSEPH PL
Mailing Address - Street 2:SUITE 210
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-3299
Mailing Address - Country:US
Mailing Address - Phone:360-254-6161
Mailing Address - Fax:360-449-1139
Practice Address - Street 1:200 NE MOTHER JOSEPH PL
Practice Address - Street 2:SUITE 110
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3299
Practice Address - Country:US
Practice Address - Phone:360-256-8584
Practice Address - Fax:360-449-1046
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005852363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9639568Medicaid
Q09647Medicare UPIN
WA8801524Medicare ID - Type Unspecified