Provider Demographics
NPI:1861024911
Name:DEVORE, HILLARY ANN (CB60988020)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:ANN
Last Name:DEVORE
Suffix:
Gender:F
Credentials:CB60988020
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4814 NE 63RD AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-2453
Mailing Address - Country:US
Mailing Address - Phone:360-713-2203
Mailing Address - Fax:
Practice Address - Street 1:9414 NE FOUTH PLAIN ROAD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662
Practice Address - Country:US
Practice Address - Phone:360-892-5142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician