MISS HILARY DAWN MONTGOMERY


Address: 1326 Nw Civic Dr # 5569, Gresham, OR 97030
Phone: 5036617733

MISS HILARY DAWN MONTGOMERY (NPI# 1912374034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912374034
Entity Type Individual
Full Name MISS HILARY DAWN MONTGOMERY
Credential PMHNP
Practice Address 1326 Nw Civic Dr # 5569
Gresham
OR 97030
Mailing Address 12600 Se Rachella Ct
Damascus
OR 97089-9641
Practice Telephone 5036617733
Mailing Telephone 5035027662
Enumeration Date 2015-08-24
Last Update Date 2019-09-06
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101YM0800X Counselor
Specialization: Mental Health
Behavioral Health & Social Service Providers
N 163WP0808X Registered Nurse
Specialization: Psych/Mental Health
201405166RN OR Nursing Service Providers
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
201907881NP-PP OR Physician Assistants & Advanced Practice Nursing Providers
N 171M00000X Case Manager/Care Coordinator Other Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
7105 Sw Varns St Ste 270, Portland, OR 972238173 5033891500
847 Ne 19th Ave, Suite 100, Portland, OR 972322684 5032380769

Office Location

Street Address 1326 NW CIVIC DR # 5569
City GRESHAM
State OR
Zip Code 97030

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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1669676193 Kimberly Sabin Nurse Practitioner 2222 E Powell Blvd, Gresham, OR 97080 2007-06-11
1447336037 Kerry E M Phifer Nurse Practitioner 1700 Nw Civic Dr, Suite 301, Gresham, OR 97030-3770 2006-10-27
1215587126 Healingspaces4u Nurse Practitioner 2951 Nw Division St Ste 120, Gresham, OR 97030-5293 2019-09-13
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1366812372 Tyler Clark Chipman Nurse Practitioner 600 Ne 8th St Ste 300, Gresham, OR 97030-7318 2015-10-02
1396947065 Susan Ruth Sagawa Nurse Practitioner 2150 Ne Division St, Ste 103, Gresham, OR 97030-5813 2007-06-04
1790806149 Daniel Ken Kamada Nurse Practitioner 333 Se 223rd Ave, Ste 204, Gresham, OR 97030-7454 2007-04-03

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Competitor

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City GRESHAM
Zip Code 97030

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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