Provider Demographics
NPI:1437193083
Name:DAVIS, MOLLY K (MD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:K
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 NW CANAL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4970
Mailing Address - Country:US
Mailing Address - Phone:206-486-8150
Mailing Address - Fax:206-775-7215
Practice Address - Street 1:126 NW CANAL ST STE 200126NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4970
Practice Address - Country:US
Practice Address - Phone:206-486-8150
Practice Address - Fax:206-775-7215
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD602082172084P0805X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORI19353Medicare UPIN