Provider Demographics
NPI:1356824452
Name:DAVIES, ALEX JAMES FELLER (PT, DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:JAMES FELLER
Last Name:DAVIES
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 WALNUT LOOP NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4417
Mailing Address - Country:US
Mailing Address - Phone:360-791-0989
Mailing Address - Fax:
Practice Address - Street 1:14802 N DEL WEBB BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2146
Practice Address - Country:US
Practice Address - Phone:623-977-2775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ30294OtherARIZONA PHYSICAL THERAPY LICENSE
CO0015846OtherCOLORADO PHYSICAL THERAPY LICENSE
WA60918764OtherWASHINGTON STATE PHYSICAL THERAPY LICENSE