Provider Demographics
NPI:1336698786
Name:GRAY, ANDREW CREED (DPT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:CREED
Last Name:GRAY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3727 CALIFORNIA AVE. SW
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116
Mailing Address - Country:US
Mailing Address - Phone:206-938-0860
Mailing Address - Fax:206-938-0866
Practice Address - Street 1:3727 CALIFORNIA AVE. SW
Practice Address - Street 2:SUITE 1-A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116
Practice Address - Country:US
Practice Address - Phone:206-938-0860
Practice Address - Fax:206-938-0866
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60653213225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist