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1558863019
BRIAN ROBERT DAVIS
PORTLAND, OR
NPI
1558863019
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: OR AT-AT-10154554)
Enumeration Date
2018-03-01
Last Update Date
2018-03-01
Business Address
BRIAN ROBERT DAVIS MS, ATC
930 SW HALL ST.
PORTLAND, OR 97201-9720
Phone number: 503-725-4073
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Mailing Address
BRIAN ROBERT DAVIS MS, ATC
6636 SW VIRGINIA AVE
PORTLAND, OR 97239-3506
Phone number: 206-919-6867
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