Basic Information
Provider Information
NPI: 1013241132
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAVIS
FirstName: RITA
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ADAMS
OtherFirstName: RITA
OtherMiddleName: ANN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: ARNP
OtherLastNameType: 1
Mailing Information
Address1: 101 W 8TH AVE
Address2:  
City: SPOKANE
State: WA
PostalCode: 992042307
CountryCode: US
TelephoneNumber: 5094743131
FaxNumber:  
Practice Location
Address1: 101 W 8TH AVE
Address2:  
City: SPOKANE
State: WA
PostalCode: 992042307
CountryCode: US
TelephoneNumber: 5094743131
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/22/2009
LastUpdateDate: 06/20/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XAP60084659WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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