Doctor Name: | MRS. DIANNE ELAINE GRAY |
NPI Number: | 1104954577 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | AP30004405 |
Business Practice Address: | 127 N Juniper St Omak, WA - 988419337 |
Business Phone Number: | 5094226593 |
Business Fax Number: | 5094220907 |
Mailing Address: | 127 N Juniper St, OMAK |
State: | WA |
Postal Code: | 988419337 |
Phone Number: | 5094226593 |
Fax Number: | 5094220907 |
NPI Enumeration Date: | 02/28/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | AP30004405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |