Individual
MS. ELISSA NOEL O GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1810 BROADWAY, BELLINGHAM, WA 98225-3133
(360) 734-9525
(360) 734-9505
Mailing address
PO BOX 1215, BELLINGHAM, WA 98227-1215
(360) 734-9525
(360) 734-9505
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00020840
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0219378
L&I
WA
Enumeration date
05/18/2007
Last updated
07/08/2007
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