Individual
RICHARD ISAAC DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
22447 24TH AVE S, DES MOINES, WA 98198-7103
(206) 631-4400
Mailing address
15675 AMBAUM BLVD SW, BURIEN, WA 98166-2523
(206) 631-3011
(206) 631-3385
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60598660
WA
Other
Enumeration date
01/22/2018
Last updated
01/22/2018
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