Healthcare Provider Details

I. General information

NPI: 1770402174
Provider Name (Legal Business Name): CAMERON T RAY RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 9TH AVE
SEATTLE WA
98104-2499
US

IV. Provider business mailing address

325 9TH AVE
SEATTLE WA
98104-2420
US

V. Phone/Fax

Practice location:
  • Phone: 206-744-3257
  • Fax:
Mailing address:
  • Phone: 206-744-3257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.RN.70138205
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: