Provider Demographics
NPI:1528602521
Name:GRACE UNFOLDING PLLC
Entity Type:Organization
Organization Name:GRACE UNFOLDING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:K
Authorized Official - Last Name:ISHII
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, AEMP , LMT
Authorized Official - Phone:206-890-0758
Mailing Address - Street 1:3614 CALIFORNIA AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-3780
Mailing Address - Country:US
Mailing Address - Phone:206-890-0758
Mailing Address - Fax:
Practice Address - Street 1:10032 15TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98146-3728
Practice Address - Country:US
Practice Address - Phone:206-890-0758
Practice Address - Fax:206-701-6537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1871540765OtherINDIVIDUAL NPI