Provider Demographics
NPI:1093216665
Name:PACE, DAMIAN AARON JR (NRP, FP-C, CCP-C)
Entity Type:Individual
Prefix:MR
First Name:DAMIAN
Middle Name:AARON
Last Name:PACE
Suffix:JR
Gender:M
Credentials:NRP, FP-C, CCP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 N HIGHVIEW LN APT 206
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-2346
Mailing Address - Country:US
Mailing Address - Phone:203-817-2152
Mailing Address - Fax:
Practice Address - Street 1:1501 N HIGHVIEW LN APT 206
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-2346
Practice Address - Country:US
Practice Address - Phone:203-817-2152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAE201402677146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic