Healthcare Provider Details

I. General information

NPI: 1295741296
Provider Name (Legal Business Name): ANDREW P DAVIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7315 212TH ST SW STE 200
EDMONDS WA
98026-7610
US

IV. Provider business mailing address

7315 212TH ST SW STE 200
EDMONDS WA
98026-7610
US

V. Phone/Fax

Practice location:
  • Phone: 425-774-2020
  • Fax:
Mailing address:
  • Phone: 425-774-2020
  • Fax: 999-999-9999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD00029453
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: