Provider Demographics
NPI:1770399362
Name:DAVIS, MICHELLE FRANCHELLE (CRM)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:FRANCHELLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14725 SE RHONE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-2556
Mailing Address - Country:US
Mailing Address - Phone:503-666-6575
Mailing Address - Fax:
Practice Address - Street 1:14725 SE RHONE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97236-2556
Practice Address - Country:US
Practice Address - Phone:503-666-6575
Practice Address - Fax:503-491-3395
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23-CRM-1924175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist