Provider Demographics
NPI:1760901698
Name:BRAY, BRIANA (RN)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:BRAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 VIEW PLACE NORTH NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-7919
Mailing Address - Country:US
Mailing Address - Phone:253-341-6619
Mailing Address - Fax:
Practice Address - Street 1:3515 VIEW PLACE NORTH NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-7919
Practice Address - Country:US
Practice Address - Phone:253-341-6619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60649510163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA163W00000XMedicaid