Individual
MARY LOUISE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADCI
Contact information
Practice address
400 NE 7TH ST, GRESHAM, OR 97030-5604
(503) 661-5455
Mailing address
11153 NE WEIDLER ST APT C3, PORTLAND, OR 97220-1974
(503) 719-0101
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/11/2007
Last updated
08/04/2011
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