Individual
ZACHARY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6605 SE LAKE RD, MILWAUKIE, OR 97222-2161
(309) 338-8657
Mailing address
6605 SE LAKE RD, MILWAUKIE, OR 97222-2161
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/18/2019
Last updated
11/13/2024
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