Provider Demographics
NPI:1588095715
Name:NAVARRE, DAVIDA E (PHD)
Entity type:Individual
Prefix:
First Name:DAVIDA
Middle Name:E
Last Name:NAVARRE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 100H ST SW
Mailing Address - Street 2:# 33
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2751
Mailing Address - Country:US
Mailing Address - Phone:253-582-0525
Mailing Address - Fax:253-582-9753
Practice Address - Street 1:5920 100TH ST SW
Practice Address - Street 2:# 33
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2751
Practice Address - Country:US
Practice Address - Phone:253-582-0525
Practice Address - Fax:253-582-0753
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60105873103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical