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General NPI Number Information
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NPI Number | 1700211513
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Entity Type | Individual
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Provider Name | JILL ANN CARTER DNP, PMHNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 09/11/2013
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 6400 SE LAKE RD STE 135
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City | PORTLAND
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State | OR
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Zip | 97222-2189
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Country | US
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Telephone | 971-430-2335
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Fax | 888-850-5616
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Provider Business Mailing Address
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Address Line | 6400 SE LAKE RD STE 135
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City | PORTLAND
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State | OR
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Zip | 97222-2189
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Country | US
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Telephone | 888-830-6088
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Fax | 888-850-5616
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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 | 096000794RN
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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 | RN00129629
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201392160NP-PP
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60411729
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License Number State | WA
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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 | 201392160NP-PP
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License Number State | OR
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