Individual
MOLLY CHRISTINE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
4805 NE GLISAN ST STE 11N, PORTLAND, OR 97213-2933
(503) 215-1350
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
201806978NP-PP
OR
363LG0600X
Gerontology Nurse Practitioner
AP60883508
WA
Other
Enumeration date
08/03/2018
Last updated
09/24/2020
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