Individual
DEBRA M DAVENPORT
Active
Individual
DEBRA M DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00002947
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039585
LABOR AND INDUSTRIES#
WA
05
—
8342842
—
WA
01
—
DA2180
BLUE SHIELD #
WA
01
—
P00216901
RAILROAD MC #
WA
01
—
US1051762
AETNA SPECIALIST PIN
WA
Enumeration date
01/18/2007
Last updated
04/07/2008
Update your record
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