Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD 00020072 | WA |
NPI | 1801878665 |
---|---|
Provider Name | Dr. Robert F Bray |
First Address | Spokane, WA 99202-2253 |
Second Address | Spokane, WA 99202-2253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 31/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8274508 | (05) | WA |
A07853 | (02) | WA |