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General NPI Number Information
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NPI Number | 1972315059
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Entity Type | Individual
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Provider Name | THERESA LYNN DAVIS LPN
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Gender | Female
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 12310 E MIRABEAU PKWY STE 500
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-2259
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Country | US
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Telephone | 509-473-4900
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Fax | 509-473-4950
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Provider Business Mailing Address
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Address Line | 12310 E MIRABEAU PKWY STE 500
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-2259
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Country | US
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Telephone | 509-473-4900
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Fax | 509-473-4950
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LP00029223
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | LP00029223
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 0000029223
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License Number State | WA
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