Provider Demographics
NPI:1396365656
Name:DAVIS-BRUNER, AMY L (HEALTH EDUCATION)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:DAVIS-BRUNER
Suffix:
Gender:F
Credentials:HEALTH EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 NW 27TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-2445
Mailing Address - Country:US
Mailing Address - Phone:509-956-8534
Mailing Address - Fax:
Practice Address - Street 1:1320 NW 27TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-2445
Practice Address - Country:US
Practice Address - Phone:509-956-8534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator