Davonna Wilson, DNP, ARNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202010502NP Issued in OR

Practice address

205 SE Spokane St Ste 300
Portland, OR 97202-6487

Phone

(888) 508-4068

Fax

(503) 506-0602

NPI assigned

Mar 23, 2009

Last updated

Sep 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Adult Child & Adolescent Psychiatric Services PA

  • Psychiatry Physician
  • Plano, TX
  • NPI 1194036459

  Single Specialty

  Medicare reassignment NPD
• DFW Psychiatry Associates PA

  • Psychiatry Physician
  • Frisco, TX
  • NPI 1932539210

  Single Specialty

  Medicare reassignment NPD
• D Wilson Apn Family Medicine and Psychiatric Services PLLC

  dba Upper Echelon Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1861001026

  Single Specialty

  NPD (past) Authorized official
• Skycloud Psychiatry LLC

  dba Skycloud Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1104446681

  Single Specialty

  NPD (past)
• Hanifa Healthcare PC

  • Psychiatry Physician
  • Fort Worth, TX
  • NPI 1427629450

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1467693366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SE SPOKANE ST STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972026487",
            "telephone_number": "888-508-4068",
            "fax_number": "503-506-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SE SPOKANE ST STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972026487",
            "telephone_number": "888-508-4068",
            "fax_number": "503-506-0602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 S Lincoln St # 100",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992014443",
            "country_code": "US",
            "telephone_number": "888-508-4068",
            "fax_number": "503-508-0602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DAVONNA",
        "name_prefix": "Miss",
        "credential": "DNP, ARNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-23",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "64659",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "240847",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61066680",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202010502NPPP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "RN61066680",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "RN1059458",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202010502NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Wilson, MD
• Chandra K Wilson, QMHA
• Chase Wilson
• Courtney Wilson
• David Jean Wilson, MD
• Deanna Marie Wilson, LMT LICENSE #13180
• Deborah Lee Wilson, PMHNP
• Deonte Mikel Wilson
• Dominique R Wilson, DNP, PMHNP, FNP
• Eric Wilson

• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.