Healthcare Provider Details

I. General information

NPI: 1861017774
Provider Name (Legal Business Name): ASHLEY R DAVIS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY R TAYLOR

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33915 1ST WAY S STE 200
FEDERAL WAY WA
98003-6396
US

IV. Provider business mailing address

2420 S UNION AVE STE 200
TACOMA WA
98405-1323
US

V. Phone/Fax

Practice location:
  • Phone: 253-838-9839
  • Fax: 253-661-9077
Mailing address:
  • Phone: 800-734-6855
  • Fax: 253-404-0506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10000225
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61075504
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: