Individual
GRACE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4800 COLLEGE ST SE, LACEY, WA 98503-4389
(360) 493-4500
(360) 412-6510
Mailing address
4800 COLLEGE ST SE, LACEY, WA 98503-4389
(360) 493-4500
(360) 412-6510
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP61681712
WA
Other
Enumeration date
06/11/2015
Last updated
07/15/2025
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