Healthcare Provider Details
I. General information
NPI: 1982954632
Provider Name (Legal Business Name): ELLEN LINNEA DAVIS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/10/2012
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 SNELL HALL
CORVALLIS OR
97331-8593
US
IV. Provider business mailing address
500 SNELL HALL
CORVALLIS OR
97331-8593
US
V. Phone/Fax
- Phone: 541-737-2131
- Fax:
- Phone: 541-737-2131
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | C3785 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: