DAVONTE PETTIS

PORTLAND, OR
NPI1962120667
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy3747P1801X Technician, Personal Care Attendant
Enumeration Date2022-08-18
Last Update Date2022-08-18
Business Address
DAVONTE PETTIS
5725 NE PRESCOTT ST
PORTLAND, OR 97218-2275
Phone number: 503-402-8101
Mailing Address
DAVONTE PETTIS
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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