Provider Demographics
NPI:1518137553
Name:DAVIS CHIROPRACTIC
Entity Type:Organization
Organization Name:DAVIS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-764-7847
Mailing Address - Street 1:PO BOX 19901
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97280-0901
Mailing Address - Country:US
Mailing Address - Phone:503-764-7847
Mailing Address - Fax:
Practice Address - Street 1:15962 BOONES FERRY RD STE 101
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-4359
Practice Address - Country:US
Practice Address - Phone:503-699-9299
Practice Address - Fax:503-699-0718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3487111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty