Individual
DR. NANCY A GRUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
611 31ST AVE SW, PUYALLUP, WA 98373-3723
(253) 848-5951
(253) 845-7073
Mailing address
3908 10TH ST SE, PUYALLUP, WA 98374-2188
(253) 848-5951
(253) 864-8954
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00030218
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0109932
LABOR AND INDUSTRIES
WA
01
—
080090744
MEDICARE RAIL ROAD
WA
05
—
1086453
—
WA
01
—
5210016
AETNA
WA
01
—
8933794
LABOR AND INDUSTRIES VOC
WA
01
—
GR9884
REGENCE RIDER
WA
Enumeration date
06/12/2006
Last updated
01/25/2016
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