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NPI Code Detail

MEDICARE: MR. BRIAN JAMES DAVIDSON BS

MEDICARE: MR. BRIAN JAMES DAVIDSON BS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorRC00048022WA

General Provider Information

NPI Number : 1336116243
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN JAMES DAVIDSON BS
Provider Business Mailing Address
First Line : 2519 NEVADA ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98226-4623
Country : US
Telephone Number : 360-933-1428
Fax Number :
Provider Business Practice Location Address
First Line : 609 NORTH SHORE DRIVE
Second Line :
City : BELLINGHAM
State : WA
Zip : 98226-4414
Country : US
Telephone Number : 360-676-6000
Fax Number : 360-676-6006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2006
Last Update Date : 07/08/2007

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Directions to “ MR. BRIAN JAMES DAVIDSON BS” Practice Location

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