Anna Davenport

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

202101602RN Issued in OR

Practice address

1312 SW Washington St
Portland, OR 97205-2327

Phone

(503) 535-1150

Fax

(503) 535-1190

NPI assigned

Oct 14, 2016

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Telecare Mental Health Services of Oregon, Inc.

  dba Telecare Multnomah County Crisis Assessment and Treatment Center

  • Mental Illness Community Based Residential Treatment Facility
  • Portland, OR
  • NPI 1124310305
  NPD (past)

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1790236701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NE M L K BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322941",
            "telephone_number": "503-232-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 SW WASHINGTON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052327",
            "telephone_number": "503-535-1150",
            "fax_number": "503-535-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "ANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-14",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "202101602RN",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Bernice Davar
• Dave 24HR Residential LLC
• Sonal B. Dave, M.D.
• Davenport Development Services LLC
• Kimberli Kevin Davenport-Holladay, MS CCCA
• Dori Christine Davenport, R.D.H.
• Gregory J Davenport, PA-C
• Jean Davenport
• Lucy Alice Davenport, RN, BSN
• Dodie Davey, LMT

• Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.