| Doctor Name: | MRS. REBECCA ANN GRAY |
| NPI Number: | 1073948071 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 201392034NP-PP |
| Business Practice Address: | 620 Ranch Rd Reedsport, OR - 974671720 |
| Business Phone Number: | 5412712163 |
| Business Fax Number: | 5412714058 |
| Mailing Address: | 620 Ranch Rd, REEDSPORT |
| State: | OR |
| Postal Code: | 974671720 |
| Phone Number: | 5412712163 |
| Fax Number: | 5412714058 |
| NPI Enumeration Date: | 09/09/2013 |
| NPI Last Update Date: | 09/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 201392034NP-PP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |