Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 00022723 | WA |
NPI | 1164428116 |
---|---|
Provider Name | Dr. Jeffrey Howard Davis |
First Address | Richmond, BRITISH COLUMBIA V7C 2C6 |
Second Address | Oak Harbor, WA 98278-4927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 08/07/2007 |