Healthcare Provider Details

I. General information

NPI: 1306628755
Provider Name (Legal Business Name): DEVON NOELLE VARNER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEVON NOELLE WOOD DNP, FNP

II. Dates (important events)

Enumeration Date: 10/19/2023
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 SE WILSON AVE
BEND OR
97702-1788
US

IV. Provider business mailing address

11120 NE 33RD PL STE 202
BELLEVUE WA
98004-1444
US

V. Phone/Fax

Practice location:
  • Phone: 541-317-3544
  • Fax:
Mailing address:
  • Phone: 206-954-4153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberXXXXXX
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: