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Individual

GRACE P. LANDEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4245 ROOSEVELT WAY NE, BOX 354770, SEATTLE, WA 98105-6008
(206) 598-4055
(206) 598-5720
Mailing address
PO BOX 24366, M/S 359107, SEATTLE, WA 98124-0366
(206) 598-8920
(206) 598-7663

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10001588
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0170441
LABOR AND INDUSTRY
WA
05
8356313
WA
Enumeration date
07/21/2006
Last updated
07/09/2007
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