Provider Demographics
NPI:1609951268
Name:DAVIS, DEBORAH J (RN)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:J
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 CARONDELET DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-3300
Mailing Address - Country:US
Mailing Address - Phone:509-943-9104
Mailing Address - Fax:509-543-2488
Practice Address - Street 1:1175 CARONDELET DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-3300
Practice Address - Country:US
Practice Address - Phone:509-943-9104
Practice Address - Fax:509-543-2488
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00104959163WP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health