IndividualActive
Chrystal Davis, DA
NPI 1467955195 · Dental Assistant · Portland, OR
Provider details
- NPI number
- 1467955195
- Entity type
- Individual
- Primary specialty
- Dental AssistantDental Providers
- Credential
- DA
- Sex
- Female
- Sole proprietor
- No
- License
- 115363 (OR)
Specialties & taxonomies
Dental Providers
Practice location
12750 Se Stark St Bldg E
Portland, OR 97233-1539
Phone: (971) 347-3009
Fax: (971) 256-3277
Approximate (ZIP-level) locationGet directions
Mailing address
1776 Sw Madison St
Portland, OR 97205-1715
Registry dates
- Enumerated
- 2018-03-08
- Last updated
- 2022-08-15
- Certified
- 2022-08-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.