Provider Demographics
NPI:1588805154
Name:DAVIS, EILEEN SHERYL (CDP, RC)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:SHERYL
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CDP, RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9415 E TRENT AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4218
Mailing Address - Country:US
Mailing Address - Phone:509-926-3361
Mailing Address - Fax:509-927-8420
Practice Address - Street 1:9415 E TRENT AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4218
Practice Address - Country:US
Practice Address - Phone:509-926-3361
Practice Address - Fax:509-927-8420
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP 00005603101YA0400X
RC 00044003101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)