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General NPI Number Information
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NPI Number | 1255095550
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Entity Type | Individual
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Provider Name | DAVID CARL STEVENS PMHNP
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Gender | Male
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Dates
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Enumeration Date | 10/24/2021
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 12360 E BURNSIDE ST
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City | PORTLAND
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State | OR
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Zip | 97233-1042
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Country | US
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Telephone | 971-279-4800
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Fax | 971-279-2051
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Provider Business Mailing Address
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Address Line | 211 SE CARUTHERS ST
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City | PORTLAND
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State | OR
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Zip | 97214-4502
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Country | US
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Telephone | 503-224-1044
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Fax | 971-260-0355
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 201041299RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP61337481
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202111950NP-PP
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN61146170
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License Number State | WA
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