MEDICARE: GRACE MINDCARE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1588405393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE MINDCARE PC

Provider Business Mailing Address
First Line	:	617 EASTLAKE AVE E STE 410
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-5681
Country	:	US
Telephone Number	:	206-312-5373
Fax Number	:	206-791-3968

Provider Business Practice Location Address
First Line	:	9311 SE 36TH ST STE 120
Second Line	:
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-3741
Country	:	US
Telephone Number	:	206-312-5373
Fax Number	:	206-791-3968

Authorized Official
Title or Position	:	COO
Name	:	NAKYUNG CHOE
Credential	:	NP
Telephone Number	:	310-780-8527

Provider Enumeration Date	:	06/05/2024
Last Update Date	:	12/17/2025

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Directions to “GRACE MINDCARE PC ” Practice Location

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