Individual
DR. NICHOLAS ANTONY DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
1465 SCURLOCK LN, MUKILTEO, WA 98275-1734
(425) 512-9764
Mailing address
PO BOX 1244, MUKILTEO, WA 98275-1244
(425) 512-9764
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
Primary
MD00025457
WA
2083X0100X
Occupational Medicine Physician
MD00025457
WA
Other
Enumeration date
01/19/2006
Last updated
05/19/2014
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