Individual
REBECCA E DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6350 NE HALSEY ST, PORTLAND, OR 97213-4720
(503) 215-2669
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6378
OR
Other
Enumeration date
11/13/2014
Last updated
11/27/2019
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