Provider Demographics
NPI:1821345836
Name:DAVIS, ELLIOTT THRASHER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ELLIOTT
Middle Name:THRASHER
Last Name:DAVIS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7407 N DIVISION ST
Mailing Address - Street 2:B
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-5689
Mailing Address - Country:US
Mailing Address - Phone:509-448-9358
Mailing Address - Fax:
Practice Address - Street 1:7407 N DIVISION ST
Practice Address - Street 2:B
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-5689
Practice Address - Country:US
Practice Address - Phone:509-448-9358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60291819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist