Provider Demographics
NPI:1053876490
Name:LEE, GRACE UNAE (FNP ARNP-C)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:UNAE
Last Name:LEE
Suffix:
Gender:F
Credentials:FNP ARNP-C
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:UNAE
Other - Last Name:HANNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18210 19TH DR SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6904
Mailing Address - Country:US
Mailing Address - Phone:253-507-0022
Mailing Address - Fax:
Practice Address - Street 1:11913 NE 195TH ST
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3147
Practice Address - Country:US
Practice Address - Phone:206-302-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60925530363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily