Richard Isaac Davidson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP60598660 Issued in WA

Practice address

22447 24TH Ave S
Des Moines, WA 98198-7103

Phone

(206) 631-4400

NPI assigned

Jan 22, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1124536305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15675 AMBAUM BLVD SW",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662523",
            "telephone_number": "206-631-3011",
            "fax_number": "206-631-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22447 24TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987103",
            "telephone_number": "206-631-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "RICHARD",
        "middle_name": "ISAAC",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-22",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP60598660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy L Cosby
• Hidi Mickelson Cramer, LAC, LMP
• Dahlia Counseling LLC
• Nhut Thi Dang, OTR/L
• Alexis Nicole David
• Mallory Lynn Davis, MD
• Martha Whitfield Davis, PHD
• Kebron Dawit
• Jessica Dawson, COTA/L
• Irish Pediangco Dela Paz, PT

• Licensed Practical Nurse in Des Moines, WA
• Providers in Des Moines, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.