Active NPI
Maya Isabel Davis
- Dermatology Physician
- Portland, OR
National Provider Identifier
1629878855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- PG230215
- Practice address
- 3303 S Bond Ave
Portland, OR 97239-4501 - Phone
- (503) 494-8311
- NPI assigned
- Mar 17, 2025
- Last updated
- Jul 15, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | PG230215 | OR | Primary |
Addresses
Primary practice location
3303 S Bond Ave
Portland, OR 97239-4501
Mailing address
5951 E Mayo Blvd
Mayo Clinic Ierb Building
Phoenix, AZ 85054
Phone (480) 301-4088
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1629878855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5951 E MAYO BLVD",
"address_2": "MAYO CLINIC IERB BUILDING",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85054",
"telephone_number": "480-301-4088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3303 S BOND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394501",
"telephone_number": "503-494-8311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MAYA",
"middle_name": "ISABEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-17",
"last_updated": "2026-07-15",
"certification_date": "2026-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "OR",
"license": "PG230215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.