Provider Demographics
NPI:1477997575
Name:WILKINSON, JANETTE MARIE (RN, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JANETTE
Middle Name:MARIE
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:RN, PMHNP-BC
Other - Prefix:MS
Other - First Name:JANETTE
Other - Middle Name:MARIE
Other - Last Name:LANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN, RN
Mailing Address - Street 1:700 NE MULTNOMAH ST STE 275
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2131
Mailing Address - Country:US
Mailing Address - Phone:503-729-1380
Mailing Address - Fax:503-841-6343
Practice Address - Street 1:700 NE MULTNOMAH ST STE 275
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2131
Practice Address - Country:US
Practice Address - Phone:503-729-1380
Practice Address - Fax:503-841-6343
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OR089003148RN163WP0808X
OR201391435NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health