Healthcare Provider Details

I. General information

NPI: 1386077592
Provider Name (Legal Business Name): GRACE VISION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2013
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 WHITE BEAR AVE N SUITE 1050
SAINT PAUL MN
55109-1215
US

IV. Provider business mailing address

3781 FAIRWAY DR
WOODBURY MN
55125-5019
US

V. Phone/Fax

Practice location:
  • Phone: 651-770-3924
  • Fax:
Mailing address:
  • Phone: 651-735-3477
  • Fax: 651-770-5316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number2339
License Number StateMN

VIII. Authorized Official

Name: DR. JEANNY MINGMY LIU-WU
Title or Position: PRESIDENT
Credential: O.D.
Phone: 651-735-3477