Provider Demographics
NPI:1679830913
Name:DAVILA, NATALIA M (PNP APRN RN)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:M
Last Name:DAVILA
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Gender:F
Credentials:PNP APRN RN
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Other - First Name:
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Mailing Address - Street 1:2690 NE KRESKY AVE
Mailing Address - Street 2:CHEHALIS
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-2412
Mailing Address - Country:US
Mailing Address - Phone:360-330-9595
Mailing Address - Fax:360-330-9560
Practice Address - Street 1:2690 NE KRESKY AVE
Practice Address - Street 2:CHEHALIS
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-2412
Practice Address - Country:US
Practice Address - Phone:360-330-9595
Practice Address - Fax:360-330-9560
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC17615363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2075618Medicaid