Provider Demographics
NPI:1720306046
Name:DAVIES, HILLARY (LMT CA BA)
Entity Type:Individual
Prefix:MRS
First Name:HILLARY
Middle Name:
Last Name:DAVIES
Suffix:
Gender:F
Credentials:LMT CA BA
Other - Prefix:MRS
Other - First Name:HILLARY
Other - Middle Name:
Other - Last Name:DAVIES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT CA BA
Mailing Address - Street 1:4805 SW OLESON RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1420
Mailing Address - Country:US
Mailing Address - Phone:503-943-9880
Mailing Address - Fax:
Practice Address - Street 1:4805 SW OLESON RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1420
Practice Address - Country:US
Practice Address - Phone:503-943-9880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16273225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist