Healthcare Provider Details

I. General information

NPI: 1871423954
Provider Name (Legal Business Name): STEVE BRIGHAM GRAY CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 SWIFT BLVD
RICHLAND WA
99352-3514
US

IV. Provider business mailing address

1406 POULES LN
CHESAPEAKE VA
23320-3044
US

V. Phone/Fax

Practice location:
  • Phone: 509-946-4611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP.AP.70143248
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001327001
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: