Davis, Mark C

Davis, Mark C is an individual health care provider with primary practice located at 5050 Ne Hoyt St Ste 138 , Portland OR 97213-2955. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Davis, Mark C can be contacted via phone (503) 238-1061.

Contact Information

Primary practice address
5050 Ne Hoyt St Ste 138 Portland OR 97213-2955
Phone: (503) 238-1061
Fax: (503) 238-0841
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA01047 Oregon

Profile Details

NPI number 1508928714
LBN Legal business name Davis, Mark C
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2006
Last updated Jul 17th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508928714 NPPES
Oregon MEDICAID 044615

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