Healthcare Provider Details

I. General information

NPI: 1609003326
Provider Name (Legal Business Name): DAVID L SESSIONS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2009
Last Update Date: 06/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 NW 12TH AVE APT 1324
PORTLAND OR
97209-4151
US

IV. Provider business mailing address

123 NW 12TH AVE APT 1324
PORTLAND OR
97209-4151
US

V. Phone/Fax

Practice location:
  • Phone: 503-735-3766
  • Fax:
Mailing address:
  • Phone: 503-735-3766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number06108
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: