Leila Davis

Primary specialty

Registered Dietetic TechnicianTaxonomy code 136A00000X

License

1057724 Issued in AR

Legal business name

LEILA DAVIS

Practice address

17806 80TH Ave NE
Kenmore, WA 98028-1806

Phone

(870) 224-5492

NPI assigned

Feb 8, 2016

Last updated

Feb 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leila Alexandra Davis, NDTR

Title

Nutrition and Diet Technicina

Phone

(870) 224-5492

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454889600000",
    "number": "1295193084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17806 80TH AVE NE",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980281806",
            "telephone_number": "870-224-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17806 80TH AVE NE",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980281806",
            "telephone_number": "870-224-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEILA DAVIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-02-08",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LEILA",
        "authorized_official_middle_name": "ALEXANDRA",
        "authorized_official_title_or_position": "NUTRITION AND DIET TECHNICINA",
        "authorized_official_telephone_number": "870-224-5492",
        "authorized_official_credential": "NDTR"
    },
    "taxonomies": [
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": "AR",
            "license": "1057724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "1057724",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Lassiter, OTR/L
• Laura Stewart DDS PLLC
• Alaro M Lawson, ARNP
• Helan Lee-Garrard, D.O., MPH
• Eugenia Lee, D.M.D., M.S.D.
• Leo S. Henrichsen,D.D.S., P.S
• Lewandowski DDS PLLC (Face Forward Orthodontics)
• Lighthouse Infusions, PLLC (Lighthouse Infusions)
• Carol Ann Lindlow, LMHC
• Yulei Liu

• Registered Dietetic Technician in Kenmore, WA
• Providers in Kenmore, WA by specialty
• Registered Dietetic Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.