Healthcare Provider Details

I. General information

NPI: 1205760808
Provider Name (Legal Business Name): GRACIELA A PIOQUINTO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 HEWITT AVE
EVERETT WA
98201-3789
US

IV. Provider business mailing address

3214 BROADWAY UNIT 404
EVERETT WA
98201-4419
US

V. Phone/Fax

Practice location:
  • Phone: 142-535-5600
  • Fax:
Mailing address:
  • Phone: 509-707-2884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: