Individual
MISS DAVONNA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, ARNP, PMHNP-BC
Contact information
Practice address
205 SE SPOKANE ST STE 300, PORTLAND, OR 97202-6487
(888) 508-4068
(503) 506-0602
Mailing address
205 SE SPOKANE ST STE 300, PORTLAND, OR 97202-6487
(888) 508-4068
(503) 506-0602
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202010502NP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
202010502NPPP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
240847
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
64659
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP61066680
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN1059458
DC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN61066680
WA
Other
Enumeration date
03/23/2009
Last updated
09/20/2023
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