Douglas Theodore Gray, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00005222 Issued in WA

Practice address

211 Parsons Ave
Yakima, WA 98908-1734

Phone

(509) 965-1179

Fax

(509) 965-1179

NPI assigned

Jul 5, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Crescent Convalescent Center

  • Skilled Nursing Facility
  • Yakima, WA
  • NPI 1427034842
  NPD (past)
• Crescent Health Care, Inc.

  • Skilled Nursing Facility
  • Yakima, WA
  • NPI 1598864589
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265846400000",
    "number": "1285631317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10822",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989091822",
            "telephone_number": "509-966-2692",
            "fax_number": "509-965-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 PARSONS AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989081734",
            "telephone_number": "509-965-1179",
            "fax_number": "509-965-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DOUGLAS",
        "middle_name": "THEODORE",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2010-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00005222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Granados, RN60538075
• Sharon M Grandi, MASSAGE THERAPIST
• Chelsea Granstrand
• Gray & Gray LLC
• Dodie Gray
• Jody Gray
• Karla W Gray, OTR/L, LICSW
• Leslie Marie Gray, M.S.
• Michael T Gray, M.S.
• Kathleen Green, MA60390909

• Clinical Social Worker in Yakima, WA
• Providers in Yakima, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.