Individual ProviderLisa S GraysonNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1100 9th Ave, Seattle, WA 98101-2756(206) 223-6600(206) 515-5811PECOS EnrollmentBased on the most recent information from CMS, provider Lisa S Grayson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1750358255Provider TypeIndividualFull NameGrayson, Lisa SCredentialCRNAGenderFemaleSole ProprietorNoEnumeration Date3/2/2006Last Updated7/24/2024Contact InformationPractice LocationPractice Address1100 9th Ave, Seattle, WA 98101-2756Phone(206) 223-6600FaxUnlisted FaxMailing LocationMailing Address1100 Olive Way, Ms M4 Pa, Seattle, WA 98101-1873Phone(206) 515-5811FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAP30005409WashingtonCode207L00000XDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseRN00107853WashingtonProvider IdentifiersIDDescriptionIssuerIDGR4213DescriptionOtherIssuerINDIVIDUAL BLUE SHIELDWashingtonID430059540DescriptionOtherIssuerRAIL ROAD MEDICAREWashingtonID9617796DescriptionMedicaidIssuerUnlistedWashington