| Doctor Name: | GRETCHEN T WAMBACH |
| NPI Number: | 1174555932 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA10004382 |
| Business Practice Address: | 565 Eureka Way Sequim, WA - 983825074 |
| Business Phone Number: | 3605820808 |
| Business Fax Number: | 3606835678 |
| Mailing Address: | 565 Eureka Way, SEQUIM |
| State: | WA |
| Postal Code: | 983825074 |
| Phone Number: | 3605820808 |
| Fax Number: | |
| NPI Enumeration Date: | 07/06/2006 |
| NPI Last Update Date: | 07/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA10004382 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |