Individual
LAURA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3036 NE MLK JR BLVD, PORTLAND, OR 97212-3053
(503) 283-3763
(503) 735-0912
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0015753
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500750822
—
OR
Enumeration date
07/20/2018
Last updated
04/19/2023
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