Provider Demographics
NPI:1881929560
Name:PACE, ANDREW PATRICK (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:PATRICK
Last Name:PACE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 S UNION AVE
Mailing Address - Street 2:SUTE B3003
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1702
Mailing Address - Country:US
Mailing Address - Phone:253-572-2842
Mailing Address - Fax:253-572-2856
Practice Address - Street 1:1901 S UNION AVE
Practice Address - Street 2:SUTE B3003
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1702
Practice Address - Country:US
Practice Address - Phone:253-572-2842
Practice Address - Fax:253-572-2856
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60329820207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology