Provider Demographics
NPI:1700261401
Name:DAVIS, DENISE REBECCA (MS)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:REBECCA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 S DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:OR
Mailing Address - Zip Code:97113-8027
Mailing Address - Country:US
Mailing Address - Phone:971-227-3300
Mailing Address - Fax:
Practice Address - Street 1:25195 SW PARKWAY AVE STE 205
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-9689
Practice Address - Country:US
Practice Address - Phone:971-227-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist