Jesse Marie Gray, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA61117627

Practice address

1412 SW 43Rd St Ste 140
Renton, WA 98057-4803

Phone

(949) 690-5830

NPI assigned

Sep 11, 2019

Sex

Female

Sole proprietor

No

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: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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

• Peninsula Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Bremerton, WA
  • NPI 1982654182
  Medicare reassignment
• Plaid Eagle Medical PLLC

  • Family Medicine Physician
  • Monroeville, PA
  • NPI 1588417117

  WA

  Medicare reassignment
• Peninsula Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Bremerton, WA
  • NPI 1407400682

  Medical

  NPD
• Peninsula Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Poulsbo, WA
  • NPI 1831912021
  NPD
• Peninsula Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Port Orchard, WA
  • NPI 1205886934
  NPD (past)

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1295384204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 SW 43RD ST STE 140",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574803",
            "telephone_number": "949-690-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 SW 43RD ST STE 140",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574803",
            "telephone_number": "949-690-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JESSE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": "PA61117627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grandcare Limited Liability Company
• Laurel Granger, M.A., L.M.H.C
• Traci Suzanne Granston, MD
• Daniel Leahy Graves, MD
• Claudia Payne Gravett, M.S.
• Fabione Green
• Jerry Eugene Green, M.A.
• Kimberly Green, M.A.
• Martin R Greget, MD
• Toni L Grewing, RN

• Medical Physician Assistant in Renton, WA
• Providers in Renton, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.