Active NPI
Cynthia Dee Gray, M.D.
- Specialist
- Vancouver, WA
National Provider Identifier
1104988336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD00028792
- Practice address
- 2101 NE 139TH St Ste 285
Vancouver, WA 98686-2326 - Phone
- (360) 892-0096
- Fax
- (360) 892-1962
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD00028792 | WA | Primary |
Addresses
Primary practice location
2101 NE 139TH St Ste 285
Vancouver, WA 98686-2326
Mailing address
3407 N Pioneer Canyon Dr
Ridgefield, WA 98642-8036
Phone (360) 869-2914
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2026 through Jan 1, 2028
Care Compare profile
Medicare Care Compare- Specialty
- Plastic and Reconstructive Surgery
- Education
- Loma Linda University School of Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2101 NE 139TH St
Suite 285
Vancouver, WA 98686-2326
Hospital & facility affiliations
- Legacy Salmon Creek Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1700809829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659052800000",
"number": "1104988336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3407 N PIONEER CANYON DR",
"city": "RIDGEFIELD",
"state": "WA",
"postal_code": "986428036",
"telephone_number": "360-869-2914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 NE 139TH ST STE 285",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986862326",
"telephone_number": "360-892-0096",
"fax_number": "360-892-1962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "CYNTHIA",
"middle_name": "DEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2022-07-29",
"certification_date": "2022-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MD00028792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.