Healthcare Provider Details

I. General information

NPI: 1093912891
Provider Name (Legal Business Name): MRS. JOAN MARIE DAVES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 W MAIN ST STE C
MONROE WA
98272-2172
US

IV. Provider business mailing address

809 W MAIN ST STE C
MONROE WA
98272-2172
US

V. Phone/Fax

Practice location:
  • Phone: 206-552-0882
  • Fax:
Mailing address:
  • Phone: 206-552-0882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberRC00016201
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: