Individual
DR. TERRY L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
29345 SW TOWN CENTER LOOP E, SUITE 110, WILSONVILLE, OR 97070-8486
(503) 582-2100
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OR MD15876
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021287
—
OR
01
—
P00981420
RR MEDICARE
OR
Enumeration date
10/17/2006
Last updated
03/09/2021
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