Individual
MR. MARK LYNN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC I
Contact information
Practice address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(503) 623-9289
Mailing address
1128 S 7TH ST, INDEPENDENCE, OR 97351-1428
(503) 838-4282
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
98-04-13
OR
Other
Enumeration date
03/27/2007
Last updated
10/23/2024
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