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NPI Code Detail

MEDICARE: ANDREW GRAY MD

MEDICARE: ANDREW GRAY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207R00000XInternal Medicine PhysicianPG230501OR

General Provider Information

NPI Number : 1770287138
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW GRAY MD
Provider Business Mailing Address
First Line : PO BOX 3777
Second Line :
City : PORTLAND
State : OR
Zip : 97208-3777
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2801 N GANTENBEIN AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97227-1623
Country : US
Telephone Number : 503-413-8407
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2023
Last Update Date : 05/13/2026

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