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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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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