Gray, Dana Robert
Gray, Dana Robert is an individual health care provider with primary practice located at 2222 Nw Lovejoy St Suite 315, Portland OR 97210-3033. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Gray, Dana Robert can be contacted via phone (503) 226-6101.Contact Information
Primary practice address
2222 Nw Lovejoy St Suite 315
Portland OR 97210-3033
Phone: (503) 226-6101
Fax: (503) 227-3422
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA00255 | Oregon |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA10003194 | Washington |
Profile Details
| NPI number | 1801888367 |
|---|---|
| LBN Legal business name | Gray, Dana Robert |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2005 |
| Last updated | Apr 18th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801888367 | NPPES |
| Washington | MEDICAID | 8434433 | |
| Washington | MEDICAID | 500603161 |
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