Individual
MRS. LONETTA ELISE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
349 SE PLAMBLAD, GRESHAM, OR 97080
(503) 933-0848
Mailing address
349 SE PLAMBLAD DR., GRESHAM, OR 97080
(503) 933-0848
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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