| John M. Gray, Md, Pllc | |
|
7713 Center Blvd Se Ste 160 Snoqualmie WA 98065-6309 | |
| (425) 292-3347 | |
| (425) 738-3020 |
| Full Name | John M. Gray, Md, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 7713 Center Blvd Se Ste 160, Snoqualmie, Washington |
| Authorized Official Name and Position | John Gray (OWNER) |
| Authorized Official Contact | 2064840053 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John M. Gray, Md, Pllc 7713 Center Blvd Se Ste 160 Snoqualmie WA 98065-6309 Ph: (425) 292-3347 | John M. Gray, Md, Pllc 7713 Center Blvd Se Ste 160 Snoqualmie WA 98065-6309 Ph: (425) 292-3347 |
| NPI Number | 1962119735 |
|---|---|
| Provider Enumeration Date | 11/01/2022 |
| Last Update Date | 02/23/2023 |
| Medicare PECOS PAC ID | 6406200443 |
|---|---|
| Medicare Enrollment ID | O20230926000899 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962119735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | John M Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770663759 PECOS PAC ID: 6507750106 Enrollment ID: I20040406001720 |
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