Provider Demographics
NPI:1609433994
Name:UNRAU, GRAYCE ANGELA (MA CCC SLP)
Entity Type:Individual
Prefix:
First Name:GRAYCE
Middle Name:ANGELA
Last Name:UNRAU
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:758 S SOLOMONS LANDING LN
Mailing Address - Street 2:
Mailing Address - City:OTHELLO
Mailing Address - State:WA
Mailing Address - Zip Code:99344-8951
Mailing Address - Country:US
Mailing Address - Phone:095-750-0768
Mailing Address - Fax:509-488-5544
Practice Address - Street 1:1025 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:OTHELLO
Practice Address - State:WA
Practice Address - Zip Code:99344-1845
Practice Address - Country:US
Practice Address - Phone:509-488-2659
Practice Address - Fax:509-488-4893
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60915515235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist