Provider Demographics
NPI:1982714317
Name:GRANDE, LUCINDA ALPERT (MD)
Entity type:Individual
Prefix:
First Name:LUCINDA
Middle Name:ALPERT
Last Name:GRANDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 CORPORATE CENTER CT SE
Mailing Address - Street 2:PIONEER FAMILY PRACTICE
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-5957
Mailing Address - Country:US
Mailing Address - Phone:360-413-8610
Mailing Address - Fax:360-413-8822
Practice Address - Street 1:5130 CORPORATE CENTER CT SE
Practice Address - Street 2:PIONEER FAMILY PRACTICE
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-5957
Practice Address - Country:US
Practice Address - Phone:360-413-8610
Practice Address - Fax:360-413-8822
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00048881207Q00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine