Provider Demographics
NPI:1376752022
Name:GRALL, COLLEEN (RN)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:GRALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:
Other - Last Name:GRALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:6007 KLICKITAT LN
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-6816
Mailing Address - Country:US
Mailing Address - Phone:509-544-7838
Mailing Address - Fax:
Practice Address - Street 1:9915 SANDIFUR PKWY
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-8941
Practice Address - Country:US
Practice Address - Phone:509-546-2222
Practice Address - Fax:509-546-2202
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00047382163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health