Provider Demographics
NPI:1093375974
Name:GRACIA, VANIA (EAMP)
Entity Type:Individual
Prefix:DR
First Name:VANIA
Middle Name:
Last Name:GRACIA
Suffix:
Gender:F
Credentials:EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11703 LUTHER AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-2839
Mailing Address - Country:US
Mailing Address - Phone:206-612-6638
Mailing Address - Fax:
Practice Address - Street 1:11703 LUTHER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-2839
Practice Address - Country:US
Practice Address - Phone:206-612-6638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60743191171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist