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Organization

DAVIES CLINIC, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEONA LYNN BRIDGEMAN MD (PRESIDENT)
(503) 266-2066
Entity
Organization

Contact information

Practice address
345 N. GRANT ST, CANBY, OR 97013
(503) 266-2066
(503) 263-8719
Mailing address
345 N. GRANT ST, CANBY, OR 97013
(503) 266-2066
(503) 263-8719

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
171066
OR
Enumeration date
06/29/2007
Last updated
12/27/2012
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