Provider Demographics
NPI:1013081454
Name:GRACEWINDS PERINATAL SERVICES, INC.
Entity type:Organization
Organization Name:GRACEWINDS PERINATAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:CLAIR
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:CMA, LMP, CCCE, CLD
Authorized Official - Phone:206-781-9871
Mailing Address - Street 1:1415 NW 70TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-5340
Mailing Address - Country:US
Mailing Address - Phone:206-781-9871
Mailing Address - Fax:206-297-8488
Practice Address - Street 1:1415 NW 70TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-5340
Practice Address - Country:US
Practice Address - Phone:206-781-9871
Practice Address - Fax:206-297-8488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty