Individual
CRYSTAL L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
139 1ST AVE. SW, CASTLE ROCK, WA 98611
(360) 274-2353
(360) 274-2354
Mailing address
224 PAINE RD, CASTLE ROCK, WA 98611-8708
(360) 274-2353
(360) 274-2354
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00019024
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1055113
AMERICAN SPECIALTY HEALTH
WA
01
—
3804HO
REGENCE BLUE SHIELD
WA
Enumeration date
01/24/2007
Last updated
07/08/2007
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