Provider Demographics
NPI:1851839682
Name:DUFFY, GRAYCEN (ARNP)
Entity Type:Individual
Prefix:
First Name:GRAYCEN
Middle Name:
Last Name:DUFFY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 CHASE AVE
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2924
Mailing Address - Country:US
Mailing Address - Phone:509-897-3700
Mailing Address - Fax:509-897-5575
Practice Address - Street 1:380 CHASE AVE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2924
Practice Address - Country:US
Practice Address - Phone:509-897-3700
Practice Address - Fax:509-897-5575
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP 60725057363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily