Active NPI
Gabriele M. Lally, PA-C
- Physician Assistant
- Tacoma, WA
National Provider Identifier
1467538223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA10004845
- Practice address
- 1708 Yakima Ave
Suite 105
Tacoma, WA 98405-5307 - Phone
- (253) 426-4420
- Fax
- (253) 426-4383
- NPI assigned
- Oct 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA10004845 | WA | Primary |
Addresses
Primary practice location
1708 Yakima Ave
Suite 105
Tacoma, WA 98405-5307
Mailing address
315 Martin Luther King Jr Way
3 Philip Pavilion
Tacoma, WA 98405-4234
Phone (253) 403-2633
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8431595 | Medicaid | WA | |
| 0259143 | Other | WA | STATE L&I |
| 335060 | Other | INTERNAL ID-MOTOR VEHICLE ID | |
| 20110221364696 | Other | WA | STATE L&I |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Physician Assistant | Past | Accepting new patients |
| Multicare Health System | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Tacoma, WA
- NPI 1124111430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491868800000",
"number": "1467538223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 MARTIN LUTHER KING JR WAY",
"address_2": "3 PHILIP PAVILION",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054234",
"telephone_number": "253-403-2633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1708 YAKIMA AVE",
"address_2": "SUITE 105",
"city": "TACOMA",
"state": "WA",
"postal_code": "984055307",
"telephone_number": "253-426-4420",
"fax_number": "253-426-4383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LALLY",
"first_name": "GABRIELE",
"middle_name": "M.",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-27",
"last_updated": "2017-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA10004845",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8431595",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE L&I",
"identifier": "0259143",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNAL ID-MOTOR VEHICLE ID",
"identifier": "335060",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE L&I",
"identifier": "20110221364696",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.