MR. DOUGLAS THEODORE GRAY (LICSW) – Clinical Social Worker, NPI 1285631317

MR. DOUGLAS THEODORE GRAY (LICSW) is a healthcare provider. based in Yakima, Washington. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. LW00005222 (WA). The NPI Number for MR. DOUGLAS THEODORE GRAY (LICSW) is 1285631317

Main info

Male
Sole Proprietor
50 Years Of Experience
Accepts Medicare Assignment
Name
MR. DOUGLAS THEODORE GRAY (LICSW)
NPI
1285631317
Phone
(509) 965-1179
Address
211 PARSONS AVE
Enumeration Date
5 July 2005
Last Update Date
11 February 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1976 (50 years ago)
PAC ID
2365348307
Professional Enrollment ID
I20100304000517
Address ID
WA989081734Ya211XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,396 CLINICAL SOCIAL WORKER in WA

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Provider Addresses for MR. DOUGLAS THEODORE GRAY (LICSW)

  • 211, Parsons Avenue, Yakima, Yakima County, Washington, 98908, United States

    YAKIMA, WA 989081734

    Phone: (509) 965-1179

    Fax: (509) 965-1179

    Type: Location

  • PO BOX 10822

    YAKIMA, WA 989091822

    Phone: (509) 966-2692

    Fax: (509) 965-1179

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-03-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100304000517IClinical Social WorkerWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98908)

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Reviews

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Frequently asked questions

Does MR. DOUGLAS THEODORE GRAY (LICSW) have a public NPI I can cite?
Public records show MR. DOUGLAS THEODORE GRAY (LICSW) under NPI 1285631317.
Should I treat MR. DOUGLAS THEODORE GRAY (LICSW) as an active provider?
Patients and plans typically see MR. DOUGLAS THEODORE GRAY (LICSW) as active in the national extract.
What services align with MR. DOUGLAS THEODORE GRAY (LICSW)'s listing?
MR. DOUGLAS THEODORE GRAY (LICSW)'s public classification highlights Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MR. DOUGLAS THEODORE GRAY (LICSW)?
MR. DOUGLAS THEODORE GRAY (LICSW) is associated with Yakima, Washington in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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