Individual
LISA DANIELLE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 397-8246
Mailing address
18801 SE 18TH ST, VANCOUVER, WA 98683-9775
(360) 984-8800
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/26/2021
Last updated
03/30/2021
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