1437390960 NPI number — DR. EVELYN E.M.O DAVIES-VENN MS., AUD

Table of content: DR. EVELYN E.M.O DAVIES-VENN MS., AUD (NPI 1437390960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437390960 NPI number — DR. EVELYN E.M.O DAVIES-VENN MS., AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAVIES-VENN
Provider First Name:
EVELYN
Provider Middle Name:
E.M.O
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MS., AUD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437390960
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4033 TALBOT RD SO.
Provider Second Line Business Mailing Address:
#230
Provider Business Mailing Address City Name:
RENTON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-656-4200
Provider Business Mailing Address Fax Number:
425-656-4258

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4033 TALBOT RD SO.
Provider Second Line Business Practice Location Address:
#230
Provider Business Practice Location Address City Name:
RENTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-656-4200
Provider Business Practice Location Address Fax Number:
425-656-4258
Provider Enumeration Date:
03/12/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  LD60061775 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X , with the licence number: LD60061775 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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