George Davison

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

RPH0014475 Issued in OR

Practice address

929 NW Garden Valley Blvd
Roseburg, OR 97471-6508

Phone

(541) 672-8581

NPI assigned

Apr 23, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1417577008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711900",
            "telephone_number": "541-672-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974716508",
            "telephone_number": "541-672-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "GEORGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-23",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH0014475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "george.davison@stores.fredmeyer.com",
            "affiliation": "Y",
            "affiliationName": "FRED MEYER STORES INC",
            "address_1": "929 NW Garden Valley Blvd",
            "city": "Roseburg",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974716508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "george.davison@stores.fredmeyer.com",
            "affiliation": "Y",
            "endpointDescription": "Fred Meyer Pharmacy",
            "affiliationName": "FRED MEYER STORES INC",
            "address_1": "929 NW Garden Valley Blvd",
            "city": "Roseburg",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974716508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kate Davis, RPH
• Koryssa Leeanne Davis, THW
• Tommy Lee Davis II
• Travis J. Davis, D.C.
• Dawn Anne Davison, PHARM.D.
• Giovanna Rozza De Faria, MCMHC
• Bryan H Deck, O.D.
• Jeni Deck
• Stephanie Dedianous
• Ryan Dehart, RN

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.