Healthcare Provider Details

I. General information

NPI: 1376196972
Provider Name (Legal Business Name): GRACE HAMLOW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19125 N CREEK PKWY
BOTHELL WA
98011-8035
US

IV. Provider business mailing address

19125 N CREEK PKWY
BOTHELL WA
98011-8035
US

V. Phone/Fax

Practice location:
  • Phone: 425-877-5227
  • Fax:
Mailing address:
  • Phone: 425-877-5227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61340812
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: