Davis, Lissa
Davis, Lissa is an individual health care provider with primary practice located at 1233 Edgewater St Nw , Salem OR 97304-4049. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Davis, Lissa can be contacted via phone (503) 378-7526.Contact Information
Primary practice address
1233 Edgewater St Nw
Salem OR 97304-4049
Phone: (503) 378-7526
Fax: (503) 480-1611
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Community Health Worker | 172V00000X |
Profile Details
| NPI number | 1427787068 |
|---|---|
| LBN Legal business name | Davis, Lissa |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2022 |
| Last updated | Jun 8th, 2022 - about 3 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 | 1427787068 | NPPES |
| Oregon | MEDICAID | 930605570 |
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