Provider Demographics
NPI:1023686029
Name:DELAP, GRACE GRETCHEN
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:GRETCHEN
Last Name:DELAP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6805 58TH DR NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-6124
Mailing Address - Country:US
Mailing Address - Phone:425-870-7121
Mailing Address - Fax:
Practice Address - Street 1:6805 58TH DR NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-6124
Practice Address - Country:US
Practice Address - Phone:425-870-7121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician