Healthcare Provider Details

I. General information

NPI: 1164731501
Provider Name (Legal Business Name): HANNAH GRACE GARCIA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH GRACE CLOWES PA-C

II. Dates (important events)

Enumeration Date: 10/04/2010
Last Update Date: 06/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 7TH AVE
SEATTLE WA
98104-1132
US

IV. Provider business mailing address

5101 9TH AVE NW APT 2
SEATTLE WA
98107-3627
US

V. Phone/Fax

Practice location:
  • Phone: 206-329-1760
  • Fax:
Mailing address:
  • Phone: 720-635-8241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9105574
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: