Individual
NATHANIEL JOHN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDC1
Contact information
Practice address
508 UPLAND ST, KENAI, AK 99611-8026
(907) 335-7500
Mailing address
PO BOX 84101, SEATTLE, WA 98124-5401
(907) 335-7500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1749657
—
AK
Enumeration date
05/15/2024
Last updated
04/03/2026
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