Greg E Davidson, CPO

Primary specialty

SpecialistTaxonomy code 174400000X

License

PS00000207 Issued in WA

Practice address

812 39TH Ave SW
Suite D
Puyallup, WA 98373-5915

Phone

(253) 651-8250

Fax

(253) 651-8250

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Davidson Prosthetics LLC

  • Prosthetic/Orthotic Supplier
  • Puyallup, WA
  • NPI 1033360409

  O20100930086749

  Same enrollment

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Davidson Prosthetics LLC

  • Prosthetic/Orthotic Supplier
  • Puyallup, WA
  • NPI 1033360409
  Authorized official Same address or phone

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505779200000",
    "number": "1639218829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 CANYON ROAD E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735915",
            "telephone_number": "253-651-8250",
            "fax_number": "253-881-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 39TH AVE SW",
            "address_2": "SUITE D",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983735915",
            "telephone_number": "253-651-8250",
            "fax_number": "253-651-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "GREG",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "CPO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2017-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "OI00000306",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "PS00000207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tobias Dean Daugherty
• Erin Ashley Dautremont, DO
• Rachelle David
• Davidson Prosthetics LLC
• David Alan Davidson, MD
• Jessica Lara Davidson, LMT
• Katherine Juarez Davidson
• Lawrence Davidson IV, LMT
• Nathan E Davidson, LCPO
• Cynthia Davis

• Specialist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.