Individual
MR. GREG E DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
812 39TH AVE SW, SUITE D, PUYALLUP, WA 98373-5915
(253) 651-8250
(253) 651-8250
Mailing address
11919 CANYON ROAD E, PUYALLUP, WA 98373-5915
(253) 651-8250
(253) 881-1397
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
OI00000306
WA
174400000X
Specialist
Primary
PS00000207
WA
Other
Enumeration date
02/05/2007
Last updated
09/19/2017
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