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General NPI Number Information
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NPI Number | 1124350814
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Entity Type | Organization
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Legal Business Name | TAMME DAVIS, D.O., PLLC
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 02/04/2010
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Provider Practice Location Address
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Address Line | 11801 NE 65TH ST SUITE A
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City | VANCOUVER
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State | WA
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Zip | 98662-5527
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Country | US
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Telephone | 360-892-0208
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Fax | 360-892-9081
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Provider Business Mailing Address
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Address Line | PO BOX 820523
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City | VANCOUVER
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State | WA
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Zip | 98682-0011
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Country | US
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Telephone | 360-892-0208
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Fax | 360-892-9081
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAMME DAVIS
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Credential | D.O.
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Telephone | 360-892-0208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | OP00001463
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License Number State | WA
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