MEDICARE: BALANCED HEALTH ADULT SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner

General Provider Information

NPI Number	:	1720959505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALANCED HEALTH ADULT SERVICES PLLC

Provider Business Mailing Address
First Line	:	8801 SAINT THOMAS DR
Second Line	:
City	:	PASCO
State	:	WA
Zip	:	99301-9000
Country	:	US
Telephone Number	:	303-585-1374
Fax Number	:

Provider Business Practice Location Address
First Line	:	8801 SAINT THOMAS DR
Second Line	:
City	:	PASCO
State	:	WA
Zip	:	99301-9000
Country	:	US
Telephone Number	:	303-585-1374
Fax Number	:

Authorized Official
Title or Position	:	AGACNP-BC
Name	:	GRACE VONDRA
Credential	:	AGACNP-BC
Telephone Number	:	303-585-1374

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	02/12/2026

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