Individual
VANESSA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 672-2691
Mailing address
1195A CITY VIEW ST, EUGENE, OR 97402-3325
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-23-2338
OR
101YM0800X
Mental Health Counselor
23-QMHA-R-3548
OR
175T00000X
Peer Specialist
—
—
Other
Enumeration date
03/16/2021
Last updated
04/24/2023
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