Individual
THOMAS C DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
12 S 8TH ST, YAKIMA, WA 98901-3020
(509) 454-4143
Mailing address
12 S 8TH ST, YAKIMA, WA 98901-3020
(509) 454-4143
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00000646
WA
171M00000X
Case Manager/Care Coordinator
CP00000646
WA
Other
Enumeration date
10/23/2018
Last updated
10/16/2023
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