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General NPI Number Information
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NPI Number | 1659423291
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Entity Type | Individual
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Provider Name | DAVID OLIVER CONANT-NORVILLE M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 18650 NW CORNELL RD SUITE 315
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City | HILLSBORO
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State | OR
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Zip | 97124-9207
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Country | US
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Telephone | 503-352-0468
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Fax | 503-352-1024
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Provider Business Mailing Address
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Address Line | 18650 NW CORNELL RD SUITE 315
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City | HILLSBORO
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State | OR
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Zip | 97124-9207
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Country | US
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Telephone | 503-352-0468
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Fax | 503-352-1024
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 13643
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2084S0010X
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Taxonomy Name | Sports Medicine (Psychiatry & Neurology) Physician
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License Number | 13643
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License Number State | OR
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