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1255808713
ILLYANA DAVIS
PUYALLUP, WA
NPI
1255808713
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CP61032956)
Enumeration Date
2018-11-01
Last Update Date
2024-10-11
Business Address
ILLYANA DAVIS SUDP
325 E PIONEER
PUYALLUP, WA 98372-3265
Phone number: 253-697-8400
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Mailing Address
ILLYANA DAVIS SUDP
1700 AIRPORT WAY S
SEATTLE, WA 98134-1618
Phone number: 206-223-3644
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