Individual
TAD LEON DAVIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
507 HOSPITAL WAY, BREWSTER, WA 98812-0507
(509) 689-2517
(509) 689-2086
Mailing address
PO BOX 577, BREWSTER, WA 98812-0577
(509) 689-2517
(509) 689-2086
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00016562
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1349703
—
WA
Enumeration date
04/04/2006
Last updated
07/08/2007
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