Deanna D. Davidson, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

OP00001498 Issued in WA

Practice address

100 3Rd St
Suite 4
Davenport, WA 99122-9730

Phone

(509) 725-6560

Fax

(509) 725-1509

NPI assigned

Jun 2, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Deanna D. Huntwork Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1053358465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 3RD ST",
            "address_2": "SUITE 1",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991229730",
            "telephone_number": "509-725-7501",
            "fax_number": "509-725-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 3RD ST",
            "address_2": "SUITE 4",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991229730",
            "telephone_number": "509-725-6560",
            "fax_number": "509-725-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "DEANNA",
        "middle_name": "D.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "OP00001498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CJ6525",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF L & I",
            "identifier": "163959",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "020053407",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101132",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8186389",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNA",
            "last_name": "HUNTWORK",
            "middle_name": "D.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cassandra Ann Clark, B.A.
• Larae S. Damschen, LMP
• Davenport Family Dentistry
• Davenport School District
• Davenport Vision Clinic, Inc.
• Dr Mobility, LLC
• James N Dunlap, M.D.
• Shannon L Dykes-Albers
• Tamra Ann Edmonds
• Alyssa Fleming, MA, CCC-SLP

• Surgery Physician in Davenport, WA
• Providers in Davenport, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.