Healthcare Provider Details

I. General information

NPI: 1033023106
Provider Name (Legal Business Name): ELIZABETH DAVISSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N 34TH ST STE 320
SEATTLE WA
98103-5296
US

IV. Provider business mailing address

5209 RUSSELL AVE NW APT 409
SEATTLE WA
98107-3920
US

V. Phone/Fax

Practice location:
  • Phone: 206-486-8270
  • Fax:
Mailing address:
  • Phone: 503-680-0516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWAA.SA.70146889
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: