Individual
TONYA DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5298
(541) 766-6835
Mailing address
530 NW 27TH ST, CORVALLIS, OR 97330-5298
(541) 766-6835
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
—
OR
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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