Provider Demographics
NPI:1558820282
Name:TOWLE, GRACE DANIELLE
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:DANIELLE
Last Name:TOWLE
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 1:10344 14TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98168-1689
Mailing Address - Country:US
Mailing Address - Phone:206-245-1086
Mailing Address - Fax:
Practice Address - Street 1:20100 60TH AVE W APT G31
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6294
Practice Address - Country:US
Practice Address - Phone:206-707-1832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376K00000X
WANC60927757376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide