MEDICARE: DR. DOREEN PHILLIPS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	209023667	IL
2	163WC0400X	Case Management Registered Nurse	859555	TX
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN95280740	CA
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NP95020768	CA
5	163WP0808X	Psychiatric/Mental Health Registered Nurse	859555	TX
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61160521	WA
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1034616	TX
8	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN2352002	MA
9	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	258356	AZ

General Provider Information

NPI Number	:	1942831565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOREEN PHILLIPS APRN

Provider Business Mailing Address
First Line	:	14090 SOUTHWEST FWY STE 300
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3679
Country	:	US
Telephone Number	:	833-744-5935
Fax Number	:	833-777-6653

Provider Business Practice Location Address
First Line	:	9036 35TH AVE SW STE B
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-3821
Country	:	US
Telephone Number	:	832-390-4630
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2020
Last Update Date	:	01/08/2026

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