Individual
DAVA MAE MCNUTT
Active
Individual
DAVA MAE MCNUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00002223
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136642525
—
WA
05
—
7022296
—
WA
01
—
P00937210
RR MEDICARE
OR
Enumeration date
11/23/2005
Last updated
11/09/2012
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