Active NPI
Laurie J. Davis, ARNP
- Nurse Practitioner
- Lacey, WA
National Provider Identifier
1477633659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP30006210
- Practice address
- 420 Golf Club Rd SE
Suite 204
Lacey, WA 98503-1048 - Phone
- (360) 493-7469
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP30006210 | WA | Primary |
Addresses
Primary practice location
420 Golf Club Rd SE
Suite 204
Lacey, WA 98503-1048
Mailing address
PO Box 1166
Everett, WA 98206-1166
Phone (425) 258-7357
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8233256 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP30006210 | WA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477633659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1166",
"city": "EVERETT",
"state": "WA",
"postal_code": "982061166",
"telephone_number": "425-258-7357",
"fax_number": "425-258-7022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 GOLF CLUB RD SE",
"address_2": "SUITE 204",
"city": "LACEY",
"state": "WA",
"postal_code": "985031048",
"telephone_number": "360-493-7469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LAURIE",
"middle_name": "J.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP30006210",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8233256",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.