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General NPI Number Information
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NPI Number | 1225763659
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Entity Type | Individual
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Provider Name | HILARY GABRIELLE DUVAUCHELLE PMHNP-BC, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 12636 SE STARK ST STE 125
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City | PORTLAND
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State | OR
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Zip | 97233-1058
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Country | US
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Telephone | 503-253-4600
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Fax | 503-253-4609
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Provider Business Mailing Address
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Address Line | 4504 SE WINDSOR CT
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City | PORTLAND
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State | OR
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Zip | 97206-1660
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10026825
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 200942957
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License Number State | OR
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