D Wilson Apn Family Medicine and Psychiatric Services PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

D WILSON APN FAMILY MEDICINE AND PSYCHIATRIC SERVICES PLLC

Doing business as

Upper Echelon Psychiatry

Practice address

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

Phone

(888) 508-4068

Fax

(503) 506-0602

NPI assigned

Jul 23, 2020

Last updated

Sep 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Davonna Wilson, DNP, PMHNPNPI 1467693366

Title

Pmhnp

Phone

(888) 508-4068

Specialties & licenses 1

Addresses

Other names 1

• UPPER ECHELON PSYCHIATRY Doing business as

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Davonna Wilson, DNP, ARNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1467693366

  Single Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1861001026",
    "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": "2512 E Evergreen Blvd # 1016",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986614323",
            "country_code": "US",
            "telephone_number": "817-821-3819",
            "fax_number": "510-275-0461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "170 S Lincoln St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992014443",
            "country_code": "US",
            "telephone_number": "888-508-4068",
            "fax_number": "503-506-0602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "D WILSON APN FAMILY MEDICINE AND PSYCHIATRIC SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-23",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DAVONNA",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "888-508-4068",
        "authorized_official_credential": "DNP, PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@upperechelonpsych.org",
            "affiliation": "N",
            "endpointDescription": "Office",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2512 E Evergreen Blvd # 1016",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986614323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "UPPER ECHELON PSYCHIATRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.