Organization
DAVERA CORPORATION
Active
Other names
REDWOOD FAMILY PRACTICE
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RAY DC, FNP (PRESIDENT)
(541) 471-1909
Entity
Organization
Contact information
Practice address
214 NE OUTLOOK AVE, GRANTS PASS, OR 97526-1412
(541) 471-1909
(541) 471-1928
Mailing address
214 NE OUTLOOK AVE, GRANTS PASS, OR 97526-1412
(541) 471-1909
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
225100000X
Physical Therapist
—
—
225700000X
Massage Therapist
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/29/2019
Last updated
03/11/2020
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