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General NPI Number Information
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NPI Number | 1467693366
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Entity Type | Individual
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Provider Name | DAVONNA WILSON DNP, ARNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/23/2009
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 205 SE SPOKANE ST STE 300
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City | PORTLAND
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State | OR
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Zip | 97202-6487
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Country | US
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Telephone | 888-508-4068
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Fax | 503-506-0602
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Provider Business Mailing Address
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Address Line | 205 SE SPOKANE ST STE 300
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City | PORTLAND
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State | OR
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Zip | 97202-6487
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Country | US
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Telephone | 888-508-4068
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Fax | 503-506-0602
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 64659
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 240847
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License Number State | AZ
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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 | AP61066680
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202010502NPPP
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN61066680
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN1059458
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License Number State | DC
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202010502NP
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License Number State | OR
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