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Individual

TODD M. DAVIDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CDPT

Contact information

Practice address
1001 BAY VIEW AVE., NEAH BAY, WA 98357
(360) 645-2461
Mailing address
1528 W. 4TH STREET, PORT ANGELES, WA 98363
(360) 452-5014

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO 60124036
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CO 60124036
CHEMICAL DEPENDENCY PROFESSIONAL TRAINEE
WA
Enumeration date
11/17/2011
Last updated
11/17/2011
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