Provider Demographics
NPI:1326697541
Name:PICHET, GRACE LAUREN
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:LAUREN
Last Name:PICHET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1922 LAWRENCE ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2734
Mailing Address - Country:US
Mailing Address - Phone:301-885-8707
Mailing Address - Fax:
Practice Address - Street 1:1922 LAWRENCE ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2734
Practice Address - Country:US
Practice Address - Phone:301-885-8707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program