Active NPI
Donna K Davis, T-24-3697
- Addiction (Substance Use Disorder) Counselor
- Portland, OR
National Provider Identifier
1902656952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- T-24-3697
- Practice address
- 11022 SE Wood Ave
Portland, OR 97222-4553 - Phone
- (503) 201-1668
- Fax
- (541) 234-3777
- NPI assigned
- Mar 25, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | T-24-3697 | OR | Primary |
Addresses
Primary practice location
11022 SE Wood Ave
Portland, OR 97222-4553
Mailing address
11022 SE Wood Ave
Portland, OR 97222-4553
Phone (503) 201-1668
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 |
|---|---|---|---|
| T-24-3697 | OR | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1902656952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11022 SE WOOD AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972224553",
"telephone_number": "503-201-1668",
"fax_number": "541-234-3777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11022 SE WOOD AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972224553",
"telephone_number": "503-201-1668",
"fax_number": "541-234-3777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DONNA",
"middle_name": "K",
"credential": "T-24-3697",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-25",
"last_updated": "2024-03-25",
"certification_date": "2024-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "T-24-3697",
"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 Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.