Individual
MALLORY DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2440 WILLAMETTE ST STE 201&202, EUGENE, OR 97405-3170
(541) 234-3090
Mailing address
2440 WILLAMETTE ST STE 201&202, EUGENE, OR 97405-3170
(541) 234-3090
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A16651
OR
Other
Enumeration date
10/09/2024
Last updated
07/02/2025
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