Provider Demographics
NPI:1023504446
Name:PACE, ANNELISE AMY (MS)
Entity type:Individual
Prefix:
First Name:ANNELISE
Middle Name:AMY
Last Name:PACE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 MADISON ST STE 500
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1388
Mailing Address - Country:US
Mailing Address - Phone:206-215-3075
Mailing Address - Fax:206-991-2367
Practice Address - Street 1:751 NE BLAKELY DR STE 1090
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-6201
Practice Address - Country:US
Practice Address - Phone:206-215-3075
Practice Address - Fax:206-991-2367
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61062206170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS