Individual
DR. RUSSELL DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
(503) 257-2500
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD187183
OR
207P00000X
Emergency Medicine Physician
Primary
Q5788
TX
Other
Enumeration date
06/29/2011
Last updated
02/27/2020
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