Provider Demographics
NPI:1851841993
Name:GRAY, WHITNEY ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ANN
Last Name:GRAY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:ANN
Other - Last Name:ERNST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14857 S BRUNNER RD
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-8749
Mailing Address - Country:US
Mailing Address - Phone:678-662-3542
Mailing Address - Fax:
Practice Address - Street 1:3270 LIBERTY RD S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4560
Practice Address - Country:US
Practice Address - Phone:503-371-0779
Practice Address - Fax:503-371-0886
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR618242251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology