Davis, Koryssa Leeanne
Davis, Koryssa Leeanne is an sole proprietor health care provider with primary practice located at 150 Ne Kenneth Ford Dr , Roseburg OR 97470-1042. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Davis, Koryssa Leeanne can be contacted via phone (541) 672-9596.Contact Information
Primary practice address
150 Ne Kenneth Ford Dr
Roseburg OR 97470-1042
Phone: (541) 672-9596
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Community Health Worker | 172V00000X | 109909 | Oregon |
Profile Details
| NPI number | 1659153906 |
|---|---|
| LBN Legal business name | Davis, Koryssa Leeanne |
| Credentials | THW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 19th, 2023 |
| Last updated | Oct 19th, 2023 - about 2 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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