Provider Demographics
NPI:1548573942
Name:DAVISON, AARON SCOTT (DC)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:SCOTT
Last Name:DAVISON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:AARON
Other - Middle Name:SCOTT
Other - Last Name:DAVISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3849 FAIRHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-3760
Mailing Address - Country:US
Mailing Address - Phone:801-440-7171
Mailing Address - Fax:
Practice Address - Street 1:8147 SW SENECA ST
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8416
Practice Address - Country:US
Practice Address - Phone:801-440-7171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor