Healthcare Provider Details

I. General information

NPI: 1831634898
Provider Name (Legal Business Name): NANCY GRZADZIELEWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2016
Last Update Date: 12/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 MADISON ST
EVERETT WA
98203-4543
US

IV. Provider business mailing address

PO BOX 2569
EVERETT WA
98213-0569
US

V. Phone/Fax

Practice location:
  • Phone: 425-212-4200
  • Fax: 425-212-4297
Mailing address:
  • Phone: 425-212-4200
  • Fax: 425-212-4297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: