Healthcare Provider Details

I. General information

NPI: 1235058439
Provider Name (Legal Business Name): GRACE POWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 440-446-8600
  • Fax: 216-844-8667
Mailing address:
  • Phone: 440-446-8600
  • Fax: 216-844-8667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number50.010656RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: