Individual
SCOTT W GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
14820 72ND AVE W, EDMONDS, WA 98026-4008
(425) 582-9421
(425) 967-7919
Mailing address
14820 72ND AVE W, EDMONDS, WA 98026-4008
(425) 582-9421
(425) 967-7919
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30000255
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000538000
—
ID
05
—
9603333
—
WA
01
—
A3557
BC ID
ID
01
—
N23405
IDAHO LICENSE
ID
01
—
P00137193
RAILROAD MEDICARE
—
Enumeration date
09/21/2005
Last updated
05/29/2014
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