Individual
MR. BARRY N. DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
12360 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9320
(503) 659-4988
(503) 698-4018
Mailing address
PO BOX 22075, MILWAUKIE, OR 97269-2075
(503) 659-4777
(503) 652-5223
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO18093
OR
207V00000X
Obstetrics & Gynecology Physician
DO18093
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054911
—
OR
01
—
080111539
RR MEDICARE
OR
Enumeration date
11/29/2005
Last updated
08/02/2010
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