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Contact Information

PRISCILLA DESVERGUNAT, NP
2801 N GANTENBEIN AVE
PORTLAND, OR97227-1623
 Phone: 503-276-9300
 Fax: 503-276-9351
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

363LP0200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for PRISCILLA DESVERGUNAT · (Female)

NPI # 1578234597
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 09/21/2021
Last updated 09/21/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • OR License # 202109745NP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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