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Ms. Mary Elizabeth Davis
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NPI Number Detailed Information
Provider Information:
| Name: | Ms. Mary Elizabeth Davis |
| Gender: | F |
| Provider License Number If Given: | AP 30000088 |
NPI Information:
| NPI: | 1780678292 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 7/9/2007 |
Provider Business Mailing Address:
| Address: | 2145 BOYER AVE E Seattle, WA 98112 |
| Phone Number: | 2063252819 |
| Fax Number: |
Provider Business Practice Location Address:
| Address: | COUNTRY DOCTOR COMMUNITY CLINIC 500 19TH AVENUE EAST Seattle, WA 98112 |
| Phone Number: | 2062991600 |
| Fax Number: |
Provider Taxonomy:
| Primary: | 363LF0000X |
| Secondary (if any): | |
| State: | WA |
