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General NPI Number Information
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NPI Number | 1518137553
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Entity Type | Organization
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Legal Business Name | DAVIS CHIROPRACTIC
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 15962 BOONES FERRY RD STE 101
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-4359
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Country | US
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Telephone | 503-699-9299
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Fax | 503-699-0718
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Provider Business Mailing Address
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Address Line | PO BOX 19901
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City | PORTLAND
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State | OR
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Zip | 97280-0901
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Country | US
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Telephone | 503-764-7847
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Fax |
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Authorized Official
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Title or Position | DR.
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Name | DR. DEBORAH K. DAVIS
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Credential | DC
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Telephone | 503-764-7847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3487
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License Number State | OR
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