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General NPI Number Information
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NPI Number | 1376064410
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Entity Type | Individual
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Provider Name | KERRY LAUREN GAMBLE FNP
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Gender | Female
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 3900 CAPITAL MALL DR SW
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City | OLYMPIA
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State | WA
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Zip | 98502-8654
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Country | US
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Telephone | 360-754-5858
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Fax |
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Provider Business Mailing Address
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Address Line | 601 MCPHEE RD SW BLDG 1
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City | OLYMPIA
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State | WA
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Zip | 98502-5080
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Country | US
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Telephone | 564-669-5050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95006721
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License Number State | CA
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