Healthcare Provider Details

I. General information

NPI: 1801628870
Provider Name (Legal Business Name): KATE GRAY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2024
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 569
POINT ROBERTS WA
98281-0569
US

IV. Provider business mailing address

PO BOX 569
POINT ROBERTS WA
98281-0569
US

V. Phone/Fax

Practice location:
  • Phone: 512-866-5666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberEMT.ES.61622635
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberNAR.NA.61601061
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number2024041573
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberMAPC.PC.61612890
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: