Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP60987585 | WA |
NPI | 1013435882 |
---|---|
Provider Name | Kristen Pace |
First Address | Olympia, WA 98502-1105 |
Second Address | Olympia, WA 98502-1105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2017 |
Last Update Date | 01/03/2021 |