Individual
KAITLYN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
77 W WASHINGTON ST, BURNS, OR 97720-1544
(541) 573-3000
Mailing address
77 W WASHINGTON ST, BURNS, OR 97720-1544
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA220261
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/02/2023
Last updated
10/09/2024
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