Individual
MR. KURT W DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2415 SE 165TH AVE, STE 104, VANCOUVER, WA 98683
(360) 694-3668
(360) 882-3566
Mailing address
2415 SE 165TH AVE, STE 104, VANCOUVER, WA 98683
(360) 694-3668
(360) 882-3566
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P000000682
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1121235
—
WA
01
—
6444400001
PTAN
WA
Enumeration date
06/20/2006
Last updated
09/06/2012
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