| Grace Mindcare Pc | |
|
9311 Se 36th St Ste 120 Mercer Island WA 98040-3741 | |
| (206) 312-5373 | |
| (206) 791-3968 |
| Full Name | Grace Mindcare Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9311 Se 36th St Ste 120, Mercer Island, Washington |
| Authorized Official Name and Position | Nakyung Choe (COO) |
| Authorized Official Contact | 3107808527 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Mindcare Pc 9311 Se 36th St Ste 120 Mercer Island WA 98040-3741 Ph: (206) 312-5373 | Grace Mindcare Pc 9311 Se 36th St Ste 120 Mercer Island WA 98040-3741 Ph: (206) 312-5373 |
| NPI Number | 1588405393 |
|---|---|
| Provider Enumeration Date | 06/05/2024 |
| Last Update Date | 03/28/2025 |
| Certification Date | 03/28/2025 |
| Medicare PECOS PAC ID | 6507383023 |
|---|---|
| Medicare Enrollment ID | O20250508000867 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588405393 | NPI | - | NPPES |
| Provider Name | Nakyung Lisa Choe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669143665 PECOS PAC ID: 0042697542 Enrollment ID: I20220523002691 |
| Provider Name | Kevin David Rodas Galindo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730663246 PECOS PAC ID: 8224417969 Enrollment ID: I20220627000810 |
| Provider Name | Annika Alvarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578215398 PECOS PAC ID: 8224399761 Enrollment ID: I20230511001716 |
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