Healthcare Provider Details

I. General information

NPI: 1962667741
Provider Name (Legal Business Name): WILLIAM A. WRAY MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 N LIDGERWOOD ST SUITE 118
SPOKANE WA
99208-5095
US

IV. Provider business mailing address

5901 N LIDGERWOOD ST SUITE 118
SPOKANE WA
99208-5095
US

V. Phone/Fax

Practice location:
  • Phone: 509-484-4591
  • Fax: 509-484-7882
Mailing address:
  • Phone: 509-484-4591
  • Fax: 509-484-7882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number00030912MD
License Number StateWA

VIII. Authorized Official

Name: DR. WILLIAM ANDREW WRAY
Title or Position: PHYSICIAN
Credential: MD
Phone: 509-484-4591