Provider Demographics
NPI:1861017774
Name:DAVIS, ASHLEY R (ARNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:R
Last Name:DAVIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:R
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2420 S UNION AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1323
Mailing Address - Country:US
Mailing Address - Phone:800-734-6855
Mailing Address - Fax:253-404-0506
Practice Address - Street 1:33915 1ST WAY S STE 200
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6396
Practice Address - Country:US
Practice Address - Phone:253-838-9839
Practice Address - Fax:253-661-9077
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61075504363LF0000X
OR10000225363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP61075504OtherSTATE LICENSE