Provider Demographics
NPI:1659817583
Name:DAVIS, YVONNE K (COMMUNITY HEALTH REP)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:K
Last Name:DAVIS
Suffix:
Gender:F
Credentials:COMMUNITY HEALTH REP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:LA PUSH
Mailing Address - State:WA
Mailing Address - Zip Code:98350
Mailing Address - Country:US
Mailing Address - Phone:360-674-4273
Mailing Address - Fax:360-374-2644
Practice Address - Street 1:560 QUILEUTE HEIGHTS
Practice Address - Street 2:QUILEUTE HEALTH CENTER
Practice Address - City:LA PUSH
Practice Address - State:WA
Practice Address - Zip Code:98350
Practice Address - Country:US
Practice Address - Phone:360-674-4273
Practice Address - Fax:360-374-2644
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker