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Contact Information

GRACE B GAMPONIA, MD
4033 TALBOT RD S
SUITE 570
RENTON, WA98055-5772
 Phone: 425-656-5400
 Fax: 425-656-5079
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adult Medicine

207QA0505X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for GRACE B GAMPONIA · (Female)

NPI # 1164450748
Status Active
Credentials MD
Entity Individual
Enumeration date 06/30/2006
Last updated 03/05/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • WA License # MD00035568
  • WA Medicaid 1043099
  • WA Medicaid 8227522
  • WA Other G8891427 MEDICARE - VALLEY MEDICAL GROUP
Hospital affiliation(s)
  • VALLEY MEDICAL CENTER - (Acute Care)
    400 S 43RD ST
    RENTON, WA 98055
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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