Provider Demographics
NPI:1386262905
Name:DAVIS, BILLIE NADINE (MS SLP)
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:NADINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3871 FAIRVIEW INDUSTRIAL DR SE STE 150
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1172
Mailing Address - Country:US
Mailing Address - Phone:503-926-4299
Mailing Address - Fax:503-926-9322
Practice Address - Street 1:3871 FAIRVIEW INDUSTRIAL DR SE STE 150
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1172
Practice Address - Country:US
Practice Address - Phone:503-926-4299
Practice Address - Fax:503-926-9322
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16793235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist