# ROGER C GRAYSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1285713271
- **Gender:** Man
- **Credential:** PAC MPAB

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | Yes |

## Other

- **Enumeration date:** 11/02/2006
- **Last updated:** 11/21/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1784206 | PREMERA BLUE CROSS | WA |
| 05 | — | 8357030 | — | WA |
| 01 | — | GAB25485 | MEDICARE PIERCE COUNTY | WA |
| 01 | — | GR6977 | REGENCE BLUE SHIELD | WA |