Grace B. Gamponia
Family Doctor - Adult Medicine
4033 Talbot Rd S Suite 570
Renton
, Washington 98055-5772
Grace B. Gamponia
Family Doctor - Adult Medicine
4033 Talbot Rd S Suite 570
Renton
, Washington 98055-5772
(425) 690-2715
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Grace B. Gamponia
- 3600 Lind Ave Sw Suite 100 Attn Credentialing
- Renton, WA
- Zip : 98057-4970
- Phone : (425) 690-2715
Second Address
- Grace B. Gamponia
- 4033 Talbot Rd S Suite 570
- Renton, WA
- Zip : 98055-5772
- Fax : (425) 656-5079
- Phone : (425) 656-5400
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | MD00035568 | WA |
National Provider Identifier
| NPI | 1164450748 |
|---|---|
| Provider Name | Grace B. Gamponia |
| First Address | Renton, WA 98057-4970 |
| Second Address | Renton, WA 98055-5772 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/06/2006 |
| Last Update Date | 05/03/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1043099 | (05) | WA |
| 8227522 | (05) | WA |
| G40724 | (02) | WA |
| G8891427 | MEDICARE - VALLEY MEDICAL GROUP (01) | WA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.