Individual
BLAIR DAVISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 N ORANGE ST STE 202, MISSOULA, MT 59802-2951
(406) 327-3362
(406) 327-3349
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(406) 327-3362
(406) 327-3349
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
LP00435
RI
2084P0800X
Psychiatry Physician
Primary
MED-PHYS-LIC-11839
MT
2084P0804X
Child & Adolescent Psychiatry Physician
LP00435
RI
Other
Enumeration date
04/23/2007
Last updated
05/10/2021
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