Healthcare Provider Details

I. General information

NPI: 1346994878
Provider Name (Legal Business Name): GABRIELLA RAE LASH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 S RURAL RD STE 3
TEMPE AZ
85283-3785
US

IV. Provider business mailing address

6655 S RURAL RD STE 3
TEMPE AZ
85283-3785
US

V. Phone/Fax

Practice location:
  • Phone: 480-831-0600
  • Fax: 480-820-3065
Mailing address:
  • Phone: 480-831-0600
  • Fax: 480-820-3065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9024
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: