Provider Demographics
NPI:1568446961
Name:RAY, TERRI ALISON (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:ALISON
Last Name:RAY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:11223 127TH PL NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-4120
Mailing Address - Country:US
Mailing Address - Phone:425-822-4411
Mailing Address - Fax:425-823-9271
Practice Address - Street 1:11100 ROOSEVELT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6234
Practice Address - Country:US
Practice Address - Phone:206-362-1378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006397363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8861571Medicare UPIN