Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | DO150254 | OR |
N | 207VG0400X | Gynecologist | 2004015322 | MO |
NPI | 1023225885 |
---|---|
Provider Name | Tamme J Davis |
First Address | Corvallis, OR 97339-1189 |
Second Address | Corvallis, OR 97330-3784 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 16/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2006063 | (05) | WA |
209102102 | (05) | MO |
F41100 | (02) |