Provider Demographics
NPI:1982832606
Name:DAVIS, VALORIE GRACE (BSN, RN)
Entity Type:Individual
Prefix:MRS
First Name:VALORIE
Middle Name:GRACE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57619 LAVA BED RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:OR
Mailing Address - Zip Code:97721-9512
Mailing Address - Country:US
Mailing Address - Phone:541-493-2250
Mailing Address - Fax:
Practice Address - Street 1:57619 LAVA BED RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:OR
Practice Address - Zip Code:97721-9512
Practice Address - Country:US
Practice Address - Phone:541-493-2250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR095000746163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health