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Individual

MISS GRACE FREDEEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CO

Contact information

Practice address
600 BROADWAY, SUITE 190, SEATTLE, WA 98122-5395
(206) 323-4040
(206) 324-0943
Mailing address
600 BROADWAY, SUITE 190, SEATTLE, WA 98122-5395
(206) 323-4040
(206) 324-0943

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
OI00000178
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9036963
WA
Enumeration date
08/13/2007
Last updated
08/13/2007
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