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1063040590
JONATHON SAMUEL DAVIS
PORTLAND, OR
NPI
1063040590
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-03-30
Last Update Date
2020-03-30
Business Address
JONATHON SAMUEL DAVIS DO
1200 NW 23RD AVE
PORTLAND, OR 97210-2906
Phone number: 503-413-7074
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Mailing Address
JONATHON SAMUEL DAVIS DO
1080 JASPER DR
WEST DES MOINES, IA 50266-3312
Phone number: 515-297-1491
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