MEDICARE: DR. SHARON-ROSE DAVIDSON FITCH D.C.

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	111N00000X	Chiropractor	CH00034025	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0151216	OTHER	WA	LABOR&INDUSTRIES
2	8932918	OTHER	WA	CRIMES VICTIMS

General Provider Information

NPI Number	:	1841401106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARON-ROSE DAVIDSON FITCH D.C.

Provider Business Mailing Address
First Line	:	5900 100TH ST SW
Second Line	:	SUITE #14
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-2749
Country	:	US
Telephone Number	:	253-581-8456
Fax Number	:	253-581-8464

Provider Business Practice Location Address
First Line	:	5900 100TH ST SW
Second Line	:	SUITE #14
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-2749
Country	:	US
Telephone Number	:	253-581-8456
Fax Number	:	253-581-8464

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

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	07/08/2007

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