Individual
TRACY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
16601 NE 80TH ST, #404, REDMOND, WA 98052-6643
(425) 496-4354
Mailing address
PO BOX 2803, REDMOND, WA 98073-2803
(425) 496-4354
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00057085
WA
Other
Enumeration date
11/16/2012
Last updated
09/26/2014
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