Provider Demographics
NPI:1568647808
Name:GRAYBEAL, RUTHE ERAKER (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:RUTHE
Middle Name:ERAKER
Last Name:GRAYBEAL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:RUTHE
Other - Middle Name:MARGARET
Other - Last Name:ERAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:209 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4267
Mailing Address - Country:US
Mailing Address - Phone:253-596-3300
Mailing Address - Fax:253-596-3301
Practice Address - Street 1:1550 N 115TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8401
Practice Address - Country:US
Practice Address - Phone:206-520-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00137578163W00000X
WAAP30007968367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9655408Medicaid
WAG8880958Medicare PIN