Individual
DAVIA FULFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2170 SE 96TH AVE APT F, PORTLAND, OR 97216-2662
(503) 810-7224
Mailing address
2170 SE 96TH AVE APT F, PORTLAND, OR 97216-2662
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
Other
Enumeration date
07/02/2026
Last updated
07/02/2026
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