Provider Demographics
NPI:1508069626
Name:DALE, LINDA MAY (LINDA DALE)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MAY
Last Name:DALE
Suffix:
Gender:F
Credentials:LINDA DALE
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:DALE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LINDA DALE, PA-C
Mailing Address - Street 1:622 PICKENS RD
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-1841
Mailing Address - Country:US
Mailing Address - Phone:509-965-0203
Mailing Address - Fax:509-965-4967
Practice Address - Street 1:246 N MISSION ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2004
Practice Address - Country:US
Practice Address - Phone:509-662-1955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10003455363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant