Individual ProviderBrooke DavisFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address506 4th St, La Grande, OR 97850-1906(541) 663-3138PECOS EnrollmentBased on the most recent information from CMS, provider Brooke Davis is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1164839320Provider TypeIndividualFull NameDavis, BrookeCredentialDOGenderFemaleSole ProprietorNoEnumeration Date7/18/2014Last Updated7/2/2020Contact InformationPractice LocationPractice Address506 4th St, La Grande, OR 97850-1906Phone(541) 663-3138Fax(541) 975-5120Mailing LocationMailing Address3600 NW Samaritan Dr, Corvallis, OR 97330-3737PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseDO198311Oregon