Individual
ARTYOM NICHOLAS DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
1100 STATION DR STE 241, DUPONT, WA 98327-9777
(253) 861-1044
Mailing address
2914 N 21ST ST, TACOMA, WA 98406-7006
(253) 861-1044
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60112076
WA
Other
Enumeration date
05/17/2010
Last updated
05/17/2010
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