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Individual

DR. MYKAH CONANT NORVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, PMHNP-BC

Contact information

Practice address
9755 SW BARNES RD STE 280, PORTLAND, OR 97225-6609
(971) 429-6244
(971) 244-8593
Mailing address
9755 SW BARNES RD STE 280, PORTLAND, OR 97225-6609
(971) 429-6244
(971) 244-8593

Taxonomy

Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
201242529RN
OR
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
RN60312665
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10003518
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP61364034
WA

Other

Enumeration date
03/02/2020
Last updated
03/11/2025
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