Provider Demographics
NPI:1568574358
Name:DAVIS, DARLEEN (ATC)
Entity Type:Individual
Prefix:
First Name:DARLEEN
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 BICKFORD AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-1749
Mailing Address - Country:US
Mailing Address - Phone:360-568-7774
Mailing Address - Fax:360-568-7779
Practice Address - Street 1:1830 BICKFORD AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-1749
Practice Address - Country:US
Practice Address - Phone:360-568-7774
Practice Address - Fax:360-568-7779
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer