Sasha Nicole Davenport Souvenir, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

331358 Issued in TX

Practice address

9040 Jackson Ave
Madigan Army Medical Center Attn MCHJ-CLQ-C
Tacoma, WA 98431

Phone

(253) 968-3025

NPI assigned

Jul 12, 2016

Last updated

Jul 12, 2016By 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 names 1

• Ms. Sasha Nicole Davenport Former name

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": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1376995423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "address_2": "MADIGAN ARMY MEDICAL CENTER ATTN MCHJ-CLQ-C",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98431",
            "telephone_number": "253-968-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "address_2": "MADIGAN ARMY MEDICAL CENTER ATTN MCHJ-CLQ-C",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98431",
            "telephone_number": "253-968-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT SOUVENIR",
        "first_name": "SASHA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "331358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SASHA",
            "last_name": "DAVENPORT",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lakshmi Datla, MD
• David Astudillo Dato
• Laila Marie Daud, SOCIAL WORKER LICSW
• Molly Daugherty
• Scott Davarn, MD
• Layah Symone Davenport-Sandling
• Amanda Michelle Davenport
• Heather Davenport, RN
• Richard Austin Davenport, LMP
• Shainah K Davia

• Licensed Practical Nurse in Tacoma, WA
• Providers in Tacoma, 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 Jul 12, 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.