Healthcare Provider Details

I. General information

NPI: 1881019370
Provider Name (Legal Business Name): ALLISON DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2014
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E FIFTH AVENUE
SPOKANE WA
99202
US

IV. Provider business mailing address

PO BOX 3649 400 E FIFTH AVENUE
SPOKANE WA
99202-3649
US

V. Phone/Fax

Practice location:
  • Phone: 509-342-3758
  • Fax:
Mailing address:
  • Phone: 509-342-3758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60443167
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: