Active NPI
Reid Thomas Davidson, DC
- Chiropractor
- Tualatin, OR
National Provider Identifier
1750866976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5933
- Practice address
- 19355 SW Mohave CT Ste 100
Tualatin, OR 97062-8631 - Phone
- (503) 486-5199
- Fax
- (503) 486-5190
- NPI assigned
- Oct 3, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5933 | OR | Primary |
Addresses
Primary practice location
19355 SW Mohave CT Ste 100
Tualatin, OR 97062-8631
Mailing address
19365 SW 65TH Ave Ste 104
Tualatin, OR 97062-9196
Phone (503) 486-5199
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801059753 | Other | OR | NOT CREDENTIALED WITH MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5933 | OR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690934400000",
"number": "1750866976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19365 SW 65TH AVE STE 104",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970629196",
"telephone_number": "503-486-5199",
"fax_number": "503-486-5190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19355 SW MOHAVE CT STE 100",
"city": "TUALATIN",
"state": "OR",
"postal_code": "970628631",
"telephone_number": "503-486-5199",
"fax_number": "503-486-5190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "REID",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-03",
"last_updated": "2023-08-02",
"certification_date": "2023-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "5933",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NOT CREDENTIALED WITH MEDICARE",
"identifier": "1801059753",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tualatin, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.