Individual provider Active NPI

Kristin Grace, LICSW

  • Social Worker
  • Seattle, WA
National Provider Identifier
1689176794
Registry record updated Mar 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LW00005728 Issued in WA
Practice address
2600 SW Holden St
Seattle, WA 98126-3505
Phone
(206) 933-7035
Fax
(206) 933-7297
NPI assigned
Mar 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LW00005728 WA Primary

Addresses

Primary practice location

2600 SW Holden St
Seattle, WA 98126-3505

Mailing address

2600 SW Holden St
Seattle, WA 98126-3505
Phone (206) 933-7035

Other identifiers 1

IdentifierTypeStateIssuer
LW00005728MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LW00005728WAMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520208000000",
    "number": "1689176794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 SW HOLDEN ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981263505",
            "telephone_number": "206-933-7035",
            "fax_number": "206-933-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SW HOLDEN ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981263505",
            "telephone_number": "206-933-7035",
            "fax_number": "206-933-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "KRISTIN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2018-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW00005728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LW00005728",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.