Individual
LISA S GRAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 OLIVE WAY, MS M4 PA, SEATTLE, WA 98101-1873
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
RN00107853
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30005409
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430059540
RAIL ROAD MEDICARE
WA
05
—
9617796
—
WA
01
—
GR4213
INDIVIDUAL BLUE SHIELD
WA
Enumeration date
03/02/2006
Last updated
07/24/2024
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