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General NPI Number Information
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NPI Number | 1962378802
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Entity Type | Individual
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Provider Name | COLLETTE MARIE DAVIS
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Gender | Female
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Dates
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Enumeration Date | 10/16/2025
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 5429 RUSSELL AVE NW STE 300
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City | SEATTLE
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State | WA
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Zip | 98107-4010
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Country | US
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Telephone | 206-783-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 9118 CENTRAL VALLEY RD NE
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City | BREMERTON
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State | WA
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Zip | 98311
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Country | US
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Telephone | 209-323-9190
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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 | MA.70040125
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License Number State | WA
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