Individual
BRIAN ROBERT DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
930 SW HALL ST., PORTLAND, OR 97201-9720
(503) 725-4073
Mailing address
6636 SW VIRGINIA AVE, PORTLAND, OR 97239-3506
(206) 919-6867
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-10154554
OR
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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