Most Relevant Information
Provider Data
| NPI Number: | 1003223694 |
| Provider Name: | COLLEEN BETTILYEN DAVENPORT PMHNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | AP60443726 |
Most Important Dates
| Enumeration Date: | 07/16/2014 |
| Last Updated: | 03/25/2022 |
Provider Practice Location
3425 13TH ST
BAKER CITY
OR
978141340
Practice Location Phone/Fax
| Phone: | 5415237400 |
| Fax: | 2535841508 |
Provider Mailing Location
3425 13TH ST
BACKER CITY
OR
978141340
Provider Mailing Phone/Fax
| Phone: | 5415237400 |
| Fax: | 5415234927 |