Individual
DANA ALEXANDRA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4020 NE FREMONT ST, PORTLAND, OR 97212-1952
(503) 449-3957
Mailing address
2941 SE TAYLOR ST, PORTLAND, OR 97214-4032
(503) 449-3957
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14015
OR
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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