Individual
COREY GLEN DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 E 13TH ST STE 111, VANCOUVER, WA 98660-3329
(360) 521-6090
Mailing address
11018 NE 98TH ST, VANCOUVER, WA 98662-2274
(360) 213-9405
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
60656485
WA
Other
Enumeration date
03/13/2018
Last updated
03/13/2018
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