Healthcare Provider Details

I. General information

NPI: 1497786735
Provider Name (Legal Business Name): REBECCA THERESA HILL CPNP,PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 10/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21210 NW MAUZEY RD
HILLSBORO OR
97124-9327
US

IV. Provider business mailing address

5415 SE MILWAUKIE AVE
PORTLAND OR
97202-4940
US

V. Phone/Fax

Practice location:
  • Phone: 503-439-9531
  • Fax: 503-531-3841
Mailing address:
  • Phone: 503-233-5405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number077038688N2 PNP PP
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP30006393
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number201150141NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: