Healthcare Provider Details

I. General information

NPI: 1952774770
Provider Name (Legal Business Name): GRACE ROSENSTIEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2015
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 S TACOMA WAY
TACOMA WA
98409-3134
US

IV. Provider business mailing address

1600 E OLIVE ST
SEATTLE WA
98122-2735
US

V. Phone/Fax

Practice location:
  • Phone: 253-300-7474
  • Fax:
Mailing address:
  • Phone: 206-302-2200
  • Fax: 206-302-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: