Bruce L Davidson, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

36990 Issued in WA

Practice address

12209 Shorewood Dr SW
Burien, WA 98146-2411

Phone

(206) 799-4513

NPI assigned

Apr 19, 2006

Last updated

May 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, HI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Pulmonary DiseaseAlso: Internal Medicine

Education

Temple University School of Medicine, 1977

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bdavidson438581@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Health & Services Washington

  dba Providence Medical Group SouthWest Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment NPD
• Public Hospital Dist No 1 Skagit

  dba Skagit Regional Clinics

  • General Practice Physician
  • Mount Vernon, WA
  • NPI 1023332749
  Medicare reassignment NPD
• St Lukes Clinic-Ala Moana Inc

  • Surgery Physician
  • Honolulu, HI
  • NPI 1568494730
  Medicare reassignment
• Providence Health & Services Washington

  dba Providence Medical Group Southwest Washington

  • General Practice Physician
  • Olympia, WA
  • NPI 1134656135
  NPD
• Public Hospital Dist No 1 Skagit

  dba Skagit Regional Health - Arlington Women's Health

  • Obstetrics & Gynecology Physician
  • Arlington, WA
  • NPI 1073554903
  NPD
• Public Hospital Dist No 1 Skagit

  dba Skagit Regional Health - Mount Vernon Physical Therapy

  • Physical Therapist
  • Mount Vernon, WA
  • NPI 1811460652
  NPD
• International Community Health Services

  • Optometrist
  • Seattle, WA
  • NPI 1376083741
  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1619932092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12209 SHOREWOOD DR SW",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981462411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12209 SHOREWOOD DR SW",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981462411",
            "telephone_number": "206-799-4513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 8th Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981043032",
            "country_code": "US",
            "telephone_number": "206-788-3700",
            "fax_number": "206-788-3706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "BRUCE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "36990",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "36990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdavidson438581@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "720 8th Ave S",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981043032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Ann Daniels
• Zoe Amy Darling, LAC
• David C Reed PLLC
• David Pius Thomas DMD MPH PLLC (David Thomas DMD)
• Kathleen David
• Davis Dental Health
• George Max Davis, DDS
• Krystal Ashley Davis, LMFT
• Martha Louise Davis, MSW
• Phyllis Davis, CDP

• Pulmonary Disease Physician in Burien, WA
• Providers in Burien, WA by specialty
• Pulmonary Disease Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.