Individual
MR. KEN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSW, CDP
Contact information
Practice address
2009 NE 117TH ST, VANCOUVER, WA 98686-4022
(360) 566-9112
(360) 566-9133
Mailing address
7571 VIRGINIA LN, VANCOUVER, WA 98664-2168
(360) 601-4120
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60382527
WA
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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