Mcnutt, Dava Mae
Mcnutt, Dava Mae is an individual health care provider with primary practice located at 1114 Georgiana St , Port Angeles WA 98362-4212. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Mcnutt, Dava Mae can be contacted via phone (360) 452-6216.Contact Information
Primary practice address
1114 Georgiana St
Port Angeles WA 98362-4212
Phone: (360) 452-6216
Fax: (360) 452-8965
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT00002223 | Washington |
Profile Details
| NPI number | 1366425225 |
|---|---|
| LBN Legal business name | Mcnutt, Dava Mae |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 23rd, 2005 |
| Last updated | Nov 9th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366425225 | NPPES |
| Oregon | Other | P00937210 | RR MEDICARE |
| Oregon | MEDICAID | 7022296 | RR MEDICARE |
| Oregon | MEDICAID | 136642525 | RR MEDICARE |
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