Individual
KATRINA ELLEN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
891 23RD ST NE, SALEM, OR 97301
(503) 364-2181
(503) 364-0364
Mailing address
3269 LORIAN LN SE, SALEM, OR 97302-3225
(503) 585-4459
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
000028939N2PNPPP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269713
—
OR
Enumeration date
03/09/2007
Last updated
03/07/2023
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