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General NPI Number Information
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NPI Number | 1013947142
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Entity Type | Individual
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Provider Name | ANGELA LORRAINE GRAY MD
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Gender | Female
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 1608 S J ST FL 1
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City | TACOMA
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State | WA
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Zip | 98405-4930
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Country | US
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Telephone | 253-274-7501
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Fax | 206-246-0468
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Provider Business Mailing Address
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Address Line | 1608 S J ST FL 1
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City | TACOMA
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State | WA
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Zip | 98405-4930
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Country | US
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Telephone | 253-274-7501
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Fax | 206-246-0468
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | ME117908
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 2015-00395
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD60930373
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License Number State | WA
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