Davis, Kurt W

Davis, Kurt W is an sole proprietor health care provider with primary practice located at 2415 Se 165Th Ave Ste 104, Vancouver WA 98683. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Davis, Kurt W can be contacted via phone (360) 694-3668.

Contact Information

Primary practice address
2415 Se 165Th Ave Ste 104 Vancouver WA 98683
Phone: (360) 694-3668
Fax: (360) 882-3566
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X P000000682 Washington

Profile Details

NPI number 1790721827
LBN Legal business name Davis, Kurt W
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 20th, 2006
Last updated Sep 6th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790721827 NPPES
Washington MEDICAID 1121235
Washington Other 6444400001

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