Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY60546231 | WA |
Y | 103TC0700X | Clinical Psychologist | PY60546231 | WA |
NPI | 1003001306 |
---|---|
Provider Name | Dr. Jane Liaw-Gray |
First Address | Bellevue, WA 98004-6672 |
Second Address | Bellevue, WA 98004-6672 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2007 |
Last Update Date | 09/03/2016 |