Davis, Tad Leon

Davis, Tad Leon is an individual health care provider with primary practice located at 507 Hospital Way , Brewster WA 98812-0507. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Davis, Tad Leon can be contacted via phone (509) 689-2517.

Contact Information

Primary practice address
507 Hospital Way Brewster WA 98812-0507
Phone: (509) 689-2517
Fax: (509) 689-2086
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD00016562 Washington

Profile Details

NPI number 1790747954
LBN Legal business name Davis, Tad Leon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2006
Last updated Jul 8th, 2007 - about 17 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 1790747954 NPPES
Washington MEDICAID 1349703

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