Provider Demographics
NPI:1275506263
Name:GURAY, EUGENIA D (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENIA
Middle Name:D
Last Name:GURAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EUGENIA
Other - Middle Name:
Other - Last Name:DAILEG-GURAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:610 S MERIDIAN
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-5908
Mailing Address - Country:US
Mailing Address - Phone:253-881-1844
Mailing Address - Fax:253-881-1925
Practice Address - Street 1:610 S MERIDIAN
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-5908
Practice Address - Country:US
Practice Address - Phone:253-881-1844
Practice Address - Fax:253-881-1925
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA207Q00000X207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8398174Medicaid
WAP00137061OtherMEDICARE OTHER-INDIVIDUAL
WACO3401OtherMEDICARE OTHER-GROUP
193400000XOtherTAXONOMY
WA8398174Medicaid
193400000XOtherTAXONOMY