Individual
MR. DAVID REID DAVISWORTH II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
51 SW LEE ST, NEWPORT, OR 97365-3823
(541) 574-5960
(541) 265-0601
Mailing address
36 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-4947
(541) 265-4194
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
601157-449
—
VA
Enumeration date
03/21/2017
Last updated
02/21/2019
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