Healthcare Provider Details

I. General information

NPI: 1477214245
Provider Name (Legal Business Name): GRACE ELIZABETH STARRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2022
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 N NORTHGATE WAY STE 216
SEATTLE WA
98133-9018
US

IV. Provider business mailing address

2111 N NORTHGATE WAY STE 216
SEATTLE WA
98133-9018
US

V. Phone/Fax

Practice location:
  • Phone: 206-385-9636
  • Fax: 360-547-7754
Mailing address:
  • Phone: 206-385-9636
  • Fax: 360-547-7754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA70037494
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: