Provider Demographics
NPI:1174260046
Name:GRAY, HAYLEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 SPYGLASS DR APT 124
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7927
Mailing Address - Country:US
Mailing Address - Phone:512-921-9980
Mailing Address - Fax:
Practice Address - Street 1:1020 WASCO ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1159
Practice Address - Country:US
Practice Address - Phone:866-216-2819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54863183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist