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General NPI Number Information
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NPI Number | 1831496215
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Entity Type | Individual
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Provider Name | DOUGLAS WILLIAM DAVIS PT
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Gender | Male
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Dates
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Enumeration Date | 02/18/2011
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Last Update Date | 02/18/2011
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Provider Practice Location Address
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Address Line | 2430 N 13TH ST
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City | SHELTON
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State | WA
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Zip | 98584-1213
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Country | US
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Telephone | 360-426-1651
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Fax |
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Provider Business Mailing Address
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Address Line | 6411 S SPRINGVIEW ST
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City | SPOKANE
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State | WA
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Zip | 99224-8814
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Country | US
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Telephone | 509-979-2900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 00006439
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | RPT1028
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License Number State | ID
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