Most Relevant Information
Provider Data
| NPI Number: | 1003459090 |
| Provider Name: | MICHAEL D DAVIDSON SUDPT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/22/2019 |
| Last Updated: | 10/22/2019 |
Provider Practice Location
201 E LINCOLN AVE STE 100
YAKIMA
WA
989012348
Practice Location Phone/Fax
| Phone: | 5094575653 |
| Fax: |
Provider Mailing Location
201 E LINCOLN AVE STE 100
YAKIMA
WA
989012348
Provider Mailing Phone/Fax
| Phone: | 5094575653 |
| Fax: |