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General NPI Number Information
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NPI Number | 1831645977
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Entity Type | Individual
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Provider Name | ELLEN DAVIS
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Gender | Female
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Dates
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Enumeration Date | 08/29/2016
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Last Update Date | 08/29/2016
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Provider Practice Location Address
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Address Line | 3302 FUHRMAN AVE E STE 110
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City | SEATTLE
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State | WA
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Zip | 98102-7115
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Country | US
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Telephone | 206-402-4012
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Fax |
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Provider Business Mailing Address
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Address Line | 1910 E CALHOUN ST
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City | SEATTLE
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State | WA
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Zip | 98112-2645
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Country | US
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Telephone | 206-605-2630
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA60689773
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License Number State | WA
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