Lana Marlene Davis, L.C.S.W.
Individual provider Active NPI Clinical Social Worker · Waldport, OR
NPI 1699749705 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1699749705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- L3513 (OR)
- Practice address
- 525 Bay Street
Waldport, OR 97394 - Phone
- (541) 453-3055
- NPI assigned
- Feb 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040615000965 | OR | Practitioner - Clinical Social Worker | 5799769014 | Practice locations: Waldport, OR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L3513 | OR | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L3513 | OR | Yes |
Addresses
Primary practice location
525 Bay Street
Waldport, OR 97394
Mailing address
9088 NW Kinglet LN
Seal Rock, OR 97376-9755
Phone (541) 563-7408
Other providers in Waldport, OR
- Coastal Pharmacies, LLC
- Allison Barbara Colman-Pinning
- County of Lincoln
- County of Lincoln
- Alycia E Cummings
- Seaheart Crumpton Elan
- Shannon Everett
- Lee A Furlong
- Patricia Ann Garrick
- Joseph Edward Handley
All providers in Waldport, OR · Clinical Social Worker in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.