Sheri Gray, RN

Individual provider Active NPI General Practice Registered Nurse · Keller, WA

NPI 1780063263 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1780063263
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
RN60699038 (WA)
Practice address
12120 S Highway 21
Keller, WA 99140-9514
Phone
(707) 798-7478
NPI assigned
May 29, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN60699038WAMDGeneral Practice Registered Nurse
278383CAMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 278383 CA
General Practice Registered Nurse 163WG0000X RN60699038 WA Yes

Addresses

Primary practice location

12120 S Highway 21
Keller, WA 99140-9514

Mailing address

12120 S Highway 21
Keller, WA 99140-9514
Phone (707) 798-7478

Other practice location 1

425 N Sycamore Ave Apt 1
Los Angeles, CA 90036-2659
Phone (661) 803-3807

Other providers in Keller, WA

All providers in Keller, WA · General Practice Registered Nurse in Washington

Sources for this page

Verify at the official NPI Registry.