Healthcare Provider Details

I. General information

NPI: 1033006150
Provider Name (Legal Business Name): PAULO VIANNEY VILELA RODRIGUES PHD, MSN, RN, BS.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1787 NE KRESKY AVE
CHEHALIS WA
98532-2302
US

IV. Provider business mailing address

607 C. STREET
WASHOUGAL WA
98671
US

V. Phone/Fax

Practice location:
  • Phone: 360-506-9212
  • Fax:
Mailing address:
  • Phone: 503-791-2920
  • Fax: 503-791-2920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP.AP.70060199-NP
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61301773
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: