Provider Demographics
NPI:1881670347
Name:BRAY, JEFFREY F (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:F
Last Name:BRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21616 76TH AVE W
Mailing Address - Street 2:#205
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7512
Mailing Address - Country:US
Mailing Address - Phone:425-640-4810
Mailing Address - Fax:425-640-4998
Practice Address - Street 1:21616 76TH AVE W
Practice Address - Street 2:#205
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7512
Practice Address - Country:US
Practice Address - Phone:425-640-4810
Practice Address - Fax:425-640-4998
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039850207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0158640OtherL&I
WA8276693Medicaid
WA1881670347Medicaid
WA0158640OtherL&I