Healthcare Provider Details

I. General information

NPI: 1528602521
Provider Name (Legal Business Name): GRACE UNFOLDING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2019
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10032 15TH AVE SW
SEATTLE WA
98146-3728
US

IV. Provider business mailing address

3614 CALIFORNIA AVE SW
SEATTLE WA
98116-3780
US

V. Phone/Fax

Practice location:
  • Phone: 206-890-0758
  • Fax: 206-701-6537
Mailing address:
  • Phone: 206-890-0758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: NANCY K ISHII
Title or Position: OWNER/PRACTITIONER
Credential: LAC, AEMP , LMT
Phone: 206-890-0758