Individual
LAURA A. DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4855 SW WESTERN AVE, BEAVERTON, OR 97005-3460
(503) 350-2404
Mailing address
PO BOX 1488, BEAVERTON, OR 97075-1488
(503) 643-6324
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0926
OR
Other
Enumeration date
10/08/2008
Last updated
07/07/2009
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