KATHLEEN RUTH DAVIS – Social Worker, NPI 1093469025

KATHLEEN RUTH DAVIS is a healthcare provider. based in Port angeles, Washington. specializing in CLINICAL SOCIAL WORKER. They hold a License No. LW61546770 (WA). The NPI Number for KATHLEEN RUTH DAVIS is 1093469025

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
KATHLEEN RUTH DAVIS
NPI
1093469025
Phone
(360) 457-0431
Address
118 E 8TH ST
Enumeration Date
8 February 2022
Last Update Date
19 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3604570431
Graduation Year
2022 (4 years ago)
PAC ID
0648707687
Group Practice PAC ID
7416845870
Professional Enrollment ID
I20250102002213
Address ID
WA983626129PO118XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

1,396 CLINICAL SOCIAL WORKER in WA

Provider Addresses for KATHLEEN RUTH DAVIS

  • 118 E 8TH ST

    PORT ANGELES, WA 983626129

    Phone: (360) 457-0431

    Fax: (360) 457-0493

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-01-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250102002213IClinical Social WorkerWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98362)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416845870View full group profile
NameSpecialtyState
Clinical Social WorkerWA
Nurse PractitionerWA
Mental Health CounselorWA
Nurse PractitionerWA
Clinical Social WorkerWA
Clinical Social WorkerWA
Mental Health CounselorNC
Mental Health CounselorWA
Nurse PractitionerWA
Mental Health CounselorWA

Reviews

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Frequently asked questions

How do I look up KATHLEEN RUTH DAVIS by NPI?
Use NPI 1093469025 when you need to reference KATHLEEN RUTH DAVIS in forms, claims, or directories.
Does this profile mean KATHLEEN RUTH DAVIS is currently active?
Yes — KATHLEEN RUTH DAVIS appears active in the national provider directory.
What kind of provider is KATHLEEN RUTH DAVIS?
The page reflects Social Worker for KATHLEEN RUTH DAVIS. Clinical services aligned with this taxonomy classification.
Where is KATHLEEN RUTH DAVIS's primary listing?
We display Port Angeles, Washington because that is what the record indicates for KATHLEEN RUTH DAVIS.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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