Individual
LUCY ALICE DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
1630 SE ELLIS ST, PORTLAND, OR 97202-5113
(503) 233-1409
Mailing address
1630 SE ELLIS ST, PORTLAND, OR 97202-5113
(503) 233-1409
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
—
OR
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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