Healthcare Provider Details
I. General information
NPI: 1245209394
Provider Name (Legal Business Name): WILLIAM A WRAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/14/2006
Last Update Date: 06/16/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
309 E. FARWELL RD SUITE 206
SPOKANE WA
99218
US
IV. Provider business mailing address
309 E. FARWELL RD SUITE 206
SPOKANE WA
99218
US
V. Phone/Fax
- Phone: 509-484-4591
- Fax: 509-484-7882
- Phone: 509-484-4591
- Fax: 509-484-7882
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | 00030912MD |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: