Individual
MRS. SANDRA JEAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
7209 COMANCHE LN SW, OLYMPIA, WA 98512-9230
(360) 357-9685
Mailing address
7209 COMANCHE LN SW, OLYMPIA, WA 98512-9230
(360) 357-9685
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60089186
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA60089186
CREDENTIAL NUMBER
—
Enumeration date
01/27/2010
Last updated
01/27/2010
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