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Individual

KIRK EDWARD DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2939 OCEAN BEACH HWY, LONGVIEW, WA 98632-3513
(360) 232-1021
Mailing address
9517 NE HAZEL DELL AVE APT 86, VANCOUVER, WA 98665-8009

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60477665
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PH60477665
STATE PHARMACY LICENSE
WA
Enumeration date
09/16/2014
Last updated
09/16/2014
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