Provider Demographics
NPI:1912301185
Name:DAVIS, DANYA LYN (LMP)
Entity Type:Individual
Prefix:MS
First Name:DANYA
Middle Name:LYN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W. LAURIDSEN BLVD
Mailing Address - Street 2:STAMPER CHIROPRACTIC
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362
Mailing Address - Country:US
Mailing Address - Phone:360-452-7827
Mailing Address - Fax:360-452-5379
Practice Address - Street 1:106 W. LAURIDSEN BLVD.
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362
Practice Address - Country:US
Practice Address - Phone:360-808-4240
Practice Address - Fax:360-452-5379
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00015329225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist