Andrew Jon Davis, QMHP,MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4907 Issued in OR

Practice address

4585 SW 185TH Ave
Aloha, OR 97007-1557

Phone

(503) 591-9280

Fax

(503) 848-2072

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marion County

  • Adult Mental Health Clinic/Center
  • Salem, OR
  • NPI 1528147782
  Medicare reassignment NPD
• Marion County

  • Methadone Clinic
  • Salem, OR
  • NPI 1386706919
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1033210562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4585 SW 185TH AVE",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970071557",
            "telephone_number": "503-591-9280",
            "fax_number": "503-848-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4585 SW 185TH AVE",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970071557",
            "telephone_number": "503-591-9280",
            "fax_number": "503-848-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ANDREW",
        "middle_name": "JON",
        "credential": "QMHP,MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "4907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellie R Daniel
• Trang Thi Dao, PHARMD
• Megan Darkins, LCSW
• Leslie Davidoff, MD
• Howard Andrew Davidson, MD
• Bethany Anne Davis
• Annabelle Lee Dean
• Jennifer Louise Debono
• Rares N Deca, D.M.D.
• Kristen Dekker

• Clinical Social Worker in Aloha, OR
• Providers in Aloha, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.