| Doctor Name: | MR. MICHAEL RAY DAVIS |
| NPI Number: | 1023261435 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LDO |
| License Number: | DO 00001859 |
| Business Practice Address: | 506 N 40th Ave Suite 101 Yakima, WA - 989084318 |
| Business Phone Number: | 5099664735 |
| Business Fax Number: | 5099664755 |
| Mailing Address: | 506 N 40th Ave, Suite 101 YAKIMA |
| State: | WA |
| Postal Code: | 989084318 |
| Phone Number: | 5099664735 |
| Fax Number: | 5099664755 |
| NPI Enumeration Date: | 10/29/2008 |
| NPI Last Update Date: | 09/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | DO 00001859 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |