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General NPI Number Information
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NPI Number | 1821898917
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Entity Type | Individual
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Provider Name | JENEVA H GRACE
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Gender | Female
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 8301 161ST AVE NE STE 202
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City | REDMOND
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State | WA
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Zip | 98052-3858
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Country | US
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Telephone | 425-979-4339
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Fax |
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Provider Business Mailing Address
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Address Line | 25748 SE 40TH ST
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City | SAMMAMISH
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State | WA
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Zip | 98029-7760
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Country | US
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Telephone | 206-841-1375
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 61652043
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License Number State | WA
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