Individual
MELISSA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C
Contact information
Practice address
19875 SW 65TH AVE STE 100, TUALATIN, OR 97062-8353
(503) 692-7785
Mailing address
PO BOX 6689, PORTLAND, OR 97228-6689
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201502767RN
OR
363LF0000X
Family Nurse Practitioner
Primary
201806007NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500747523
—
OR
Enumeration date
07/26/2018
Last updated
10/01/2024
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