Individual
AUDREY H DAVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
18976 NW SQUIRRELTAIL LOOP, BEND, OR 97703-5932
(801) 560-4386
Mailing address
18976 NW SQUIRRELTAIL LOOP, BEND, OR 97703-5932
(801) 560-4386
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD158647
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500648688
—
OR
01
—
P01138391
MEDICARE RAILROAD
OR
Enumeration date
05/06/2009
Last updated
09/16/2019
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