Active NPI
Donna A Gray, CDP
- Professional Counselor
- Arlington, WA
National Provider Identifier
1205069671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CP00003480
- Practice address
- 21123 Smokey Point Blvd
Arlington, WA 98223-4224 - Phone
- (360) 652-9640
- Fax
- (360) 652-2093
- NPI assigned
- Sep 1, 2009
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CP00003480 | WA | Primary |
Addresses
Primary practice location
21123 Smokey Point Blvd
Arlington, WA 98223-4224
Mailing address
21123 Smokey Point Blvd
Arlington, WA 98223-4224
Phone (360) 652-9640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1994565 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP00003480 | WA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251763200000",
"number": "1205069671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21123 SMOKEY POINT BLVD",
"city": "ARLINGTON",
"state": "WA",
"postal_code": "982234224",
"telephone_number": "360-652-9640",
"fax_number": "360-652-2093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21123 SMOKEY POINT BLVD",
"city": "ARLINGTON",
"state": "WA",
"postal_code": "982234224",
"telephone_number": "360-652-9640",
"fax_number": "360-652-2093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "DONNA",
"middle_name": "A",
"credential": "CDP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-01",
"last_updated": "2009-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WA",
"license": "CP00003480",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1994565",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arlington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.