Individual provider · Type 1 NPI

Dominique R. Wilson, DNP, PMHNP, FNP

Psychiatric/Mental Health Nurse Practitioner · Portland, OR

NPI number 1295019909 Active

Practice location

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

Fax (503) 386-3366

Other practice locations

  • 401 Broadway Ste 100, Tacoma, WA 98402-3900 · (855) 704-2004
  • 2000 E Lamar Blvd Ste 600, Arlington, TX 76006-7361 · (855) 704-2004

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000XAP119115 (TX)
Family Nurse Practitioner 363LF0000X202100794NPPP (OR)
Psychiatric/Mental Health Nurse Practitioner 363LP0808XAP61131624 (WA)
Psychiatric/Mental Health Nurse Practitioner 363LP0808XAP119115 (TX)
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X202100794NP (OR)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1295019909

Dominique R. Wilson, DNP, PMHNP, FNP's National Provider Identifier is 1295019909, issued on Sep 30, 2011. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Portland, OR. The record was last updated on Oct 4, 2026.