Provider Demographics
NPI:1881831022
Name:GATTERMAN, FAYE A (LMP)
Entity Type:Individual
Prefix:MRS
First Name:FAYE
Middle Name:A
Last Name:GATTERMAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 BARCLIFT LN SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-4020
Mailing Address - Country:US
Mailing Address - Phone:360-870-3150
Mailing Address - Fax:
Practice Address - Street 1:222 KENYON ST NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-4553
Practice Address - Country:US
Practice Address - Phone:360-870-3150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024886174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist