Individual
JESSICA LYNN DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(503) 623-9289
Mailing address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(503) 623-9289
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/14/2017
Last updated
07/06/2022
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