MEDICARE: LOUISE DAVIDSON TOWNSEND MA, CDPT

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	60105374

General Provider Information

NPI Number	:	1740629054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUISE DAVIDSON TOWNSEND MA, CDPT

Provider Business Mailing Address
First Line	:	17018 15TH AVE NE
Second Line	:
City	:	SHORELINE
State	:	WA
Zip	:	98155-5126
Country	:	US
Telephone Number	:	206-362-7282
Fax Number	:	206-362-7152

Provider Business Practice Location Address
First Line	:	1134 19TH AVE E
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-3505
Country	:	US
Telephone Number	:	206-979-2043
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2013
Last Update Date	:	06/19/2013

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