Davisworth Ii, David Reid

Davisworth Ii, David Reid is an individual health care provider with primary practice located at 51 Sw Lee St , Newport OR 97365-3823. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Case Manager/Care Coordinator is his primary health care specialty. Davisworth Ii, David Reid can be contacted via phone (541) 574-5960.

Contact Information

Primary practice address
51 Sw Lee St Newport OR 97365-3823
Phone: (541) 574-5960
Fax: (541) 265-0601
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1124559307
LBN Legal business name Davisworth Ii, David Reid
Credentials QMHA
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2017
Last updated Feb 21st, 2019 - about 6 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 1124559307 NPPES
Virginia MEDICAID 601157-449

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