Provider Demographics
NPI:1689556508
Name:ONDARA, GRACE
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:ONDARA
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 1:500 E GRANT ST APT 310
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-1427
Mailing Address - Country:US
Mailing Address - Phone:952-715-7733
Mailing Address - Fax:
Practice Address - Street 1:1911 NICOLLET AVE # 230
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-3747
Practice Address - Country:US
Practice Address - Phone:952-715-7733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder