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General NPI Number Information
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NPI Number | 1982345278
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Entity Type | Individual
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Provider Name | GRACE VONDRA
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Gender | Female
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Dates
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Enumeration Date | 04/02/2022
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 2315 STOCKTON BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95817-2201
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Country | US
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Telephone | 303-585-1374
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Fax |
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Provider Business Mailing Address
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Address Line | 8801 SAINT THOMAS DR
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City | PASCO
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State | WA
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Zip | 99301-9000
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Country | US
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Telephone | 303-585-1374
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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 | 363LC0200X
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Taxonomy Name | Critical Care Medicine Nurse Practitioner
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License Number | 0997131
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95020982
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP61551401
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP61551401
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1094698
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License Number State | TX
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