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General NPI Number Information
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NPI Number | 1306606207
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Entity Type | Organization
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Legal Business Name | GRACE FORD PLLC
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Dates
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Enumeration Date | 03/20/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 108 S JACKSON ST STE 301
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City | SEATTLE
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State | WA
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Zip | 98104-2872
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Country | US
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Telephone | 980-981-4738
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Fax | 206-702-2810
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Provider Business Mailing Address
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Address Line | 108 S JACKSON ST STE 301
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City | SEATTLE
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State | WA
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Zip | 98104-2872
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Country | US
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Telephone | 980-981-4738
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Fax | 206-702-2810
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Authorized Official
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Title or Position | OWNER
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Name | KRISTINE GRACE FORD
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Credential | LMHC
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Telephone | 980-981-4738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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