Individual
MR. MARK ANTHONY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
1520 KELLY PL, WALLA WALLA, WA 99362-8607
(509) 575-4084
Mailing address
1520 KELLY PL, WALLA WALLA, WA 99362-8607
(509) 575-4084
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61526319
WA
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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