Davenport, Colleen Bettilyen

Davenport, Colleen Bettilyen is an sole proprietor health care provider with primary practice located at 3425 13Th St , Baker City OR 97814-1340. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Davenport, Colleen Bettilyen can be contacted via phone (541) 523-7400.

Contact Information

Primary practice address
3425 13Th St Baker City OR 97814-1340
Phone: (541) 523-7400
Fax: (253) 584-1508
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP60443726 Washington
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult 364SP0809X AP60443726 Washington
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 201909237NP-PP Oregon

Profile Details

NPI number 1003223694
LBN Legal business name Davenport, Colleen Bettilyen
Credentials PMHNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 16th, 2014
Last updated Mar 25th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003223694 NPPES
Oregon MEDICAID 500770467

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