Individual
STEPHANIE L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2000
(360) 414-7555
Mailing address
PO BOX 3002, LONGVIEW, WA 98632-0302
(360) 414-2000
(360) 414-7555
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD60014023
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0237288
LABOR AND INDUSTRIES
WA
05
—
024652
—
OR
05
—
8516262
—
WA
Enumeration date
05/18/2007
Last updated
04/08/2010
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