Phipps-Davisson, Corey
Phipps-Davisson, Corey is an sole proprietor health care provider with primary practice located at 319 Ne Russet St , Portland OR 97211-2815. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Phipps-Davisson, Corey can be contacted via phone (503) 289-5571.Contact Information
Primary practice address
319 Ne Russet St
Portland OR 97211-2815
Phone: (503) 289-5571
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | P160548479 | Washington |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant | 225200000X | 09165 | Oregon |
Profile Details
| NPI number | 1073990891 |
|---|---|
| LBN Legal business name | Phipps-Davisson, Corey |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 30th, 2015 |
| Last updated | Apr 30th, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073990891 | NPPES |
| Washington | Other | P160548479 | PTA LICENSE |
| Washington | Other | 09165 | PTA LICENSE |
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