Provider Demographics
NPI:1164194171
Name:GRAY, JAMES CHRISTIAN (DNP, PMHNP)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CHRISTIAN
Last Name:GRAY
Suffix:
Gender:M
Credentials:DNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9450 SW GEMINI DR # 63432
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7105
Mailing Address - Country:US
Mailing Address - Phone:503-218-3760
Mailing Address - Fax:
Practice Address - Street 1:9450 SW GEMINI DR # 63432
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-7105
Practice Address - Country:US
Practice Address - Phone:503-218-3760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202110540RN163W00000X
WARN61630969163W00000X
WAAP61630979363LP0808X
OR10029068363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse