Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ML 60469332 | WA |
Y | 2080P0214X | Pediatric Pulmonologist | MD60757308 | WA |
NPI | 1275951188 |
---|---|
Provider Name | Ms. Chelsea Davis |
First Address | Seattle, WA 98105 |
Second Address | Seattle, WA 98105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2014 |
Last Update Date | 27/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD60757308 | MEDICAL LICENSE (01) | WA |