Individual
JONATHAN MARK DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-2072
Mailing address
PO BOX 94645, SEATTLE, WA 98124-6945
(509) 474-2072
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
43667
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60326666
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000505663
BLUE CROSS
KY
05
—
999999
—
KY
01
—
P00373547
RAILROAD MEDICARE
KY
Enumeration date
01/10/2007
Last updated
11/25/2014
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