Healthcare Provider Details

I. General information

NPI: 1528331410
Provider Name (Legal Business Name): KEVIN CADE MCCRAY PHARM. D., LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2012
Last Update Date: 10/16/2024
Certification Date: 10/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14010 N DOUGLAS HWY
JUNEAU AK
99801-7600
US

IV. Provider business mailing address

7701 DEBARR RD
ANCHORAGE AK
99504-1845
US

V. Phone/Fax

Practice location:
  • Phone: 208-604-2132
  • Fax:
Mailing address:
  • Phone: 907-269-1733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number27257
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227304
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHAP2022
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: