Healthcare Provider Details

I. General information

NPI: 1306377262
Provider Name (Legal Business Name): MARY GRACE BRADY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY GRACE BRUMMITT NP

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE STE 110
SEATTLE WA
98101-2288
US

IV. Provider business mailing address

1 EMBARCADERO CTR STE 1900
SAN FRANCISCO CA
94111-3723
US

V. Phone/Fax

Practice location:
  • Phone: 206-267-4390
  • Fax:
Mailing address:
  • Phone: 415-658-6791
  • Fax: 415-520-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN60668158
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60786827
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: