Provider Demographics
NPI:1124350814
Name:TAMME DAVIS, D.O., PLLC
Entity type:Organization
Organization Name:TAMME DAVIS, D.O., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMME
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:360-892-0208
Mailing Address - Street 1:PO BOX 820523
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-0011
Mailing Address - Country:US
Mailing Address - Phone:360-892-0208
Mailing Address - Fax:360-892-9081
Practice Address - Street 1:11801 NE 65TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-5527
Practice Address - Country:US
Practice Address - Phone:360-892-0208
Practice Address - Fax:360-892-9081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001463261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty