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
Fax:
Website:

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073990891 NPPES
Washington Other P160548479 PTA LICENSE
Washington Other 09165 PTA LICENSE

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