Provider Demographics
NPI:1104284181
Name:GRAMORE, CAERA (BA, CPC, MSW)
Entity type:Individual
Prefix:
First Name:CAERA
Middle Name:
Last Name:GRAMORE
Suffix:
Gender:F
Credentials:BA, CPC, MSW
Other - Prefix:
Other - First Name:CAERA
Other - Middle Name:
Other - Last Name:AISLINGEACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3810
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98213-8810
Mailing Address - Country:US
Mailing Address - Phone:425-349-8479
Mailing Address - Fax:425-349-7217
Practice Address - Street 1:2801 LOMBARD AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3619
Practice Address - Country:US
Practice Address - Phone:425-349-8479
Practice Address - Fax:425-349-7905
Is Sole Proprietor?:No
Enumeration Date:2016-02-04
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60455619101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health