Individual
JASON L DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9040 FITZSIMMONS DR, JOINT BASE LEWIS MCCHORD, WA 98431-1000
(253) 968-3229
(253) 968-0100
Mailing address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-4900
(541) 706-2398
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
L0784
TX
207RC0000X
Cardiovascular Disease Physician
Primary
MD00046375
WA
207RC0000X
Cardiovascular Disease Physician
MD207771
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NM
Enumeration date
08/30/2006
Last updated
01/20/2022
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