DR. JENNY LUPOVICI WILSON (NPI# 1205094406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205094406 |
| Entity Type | Individual |
| Full Name | DR. JENNY LUPOVICI WILSON |
| Credential | M.D. |
| Practice Address |
707 Sw Gaines St Portland OR 97239-2901 |
| Practice Telephone | 5034949113 |
| Mailing Telephone | 5038046824 |
| Enumeration Date | 2008-05-26 |
| Last Update Date | 2013-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
MD441944 | PA | Allopathic & Osteopathic Physicians |
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
MD162292 | OR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376055004 | Jenny Vivian Wilson | Registered Nurse | 17301 East 24 Hwy, Independence, MO 64056 | 2017-11-03 |
| 1144609959 | Jenny Marie Wilson | Counselor | 730 Medical Center Ct, Chula Vista, CA 91911-6618 | 2015-05-26 |
| 1891037503 | Jenny R Wilson | Nurse Anesthetist, Certified Registered | 232 W 25th St, Erie, PA 16544-0002 | 2013-03-20 |
| 1093071805 | Jenny L Wilson | Registered Nurse | 3601 N May Ave, Suite C, Oklahoma City, OK 73112-6641 | 2012-04-05 |
| Street Address |
707 SW GAINES ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-2901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184613960 | Laurie Armsby | Pediatrics | 707 Sw Gaines St, Cdrc-p, Portland, OR 97239-2901 | 2005-10-14 |
| 1851904759 | Debra Crawford | Physical Therapist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2020-08-28 |
| 1437761574 | Lauren Nicole Beckett | Speech-Language Pathologist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2020-08-19 |
| 1720699739 | Rachel Kirsten Greene | Psychologist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2020-08-13 |
| 1356970008 | Emily Knell Spaeth | Physical Therapist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2020-04-05 |
| 1720617798 | Paula Tran | Occupational Therapist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2020-04-02 |
| 1760038111 | Natalie Alexandra Galvan | Speech-Language Pathologist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2019-08-12 |
| 1932752466 | Janvi S. Patel | Occupational Therapist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2019-07-23 |
| 1033761119 | Danielle Moyer | Psychologist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2019-07-10 |
| 1790268779 | Lily Gullion | Occupational Therapist | 707 Sw Gaines St, Portland, OR 97239-2901 | 2018-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
| 1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
| 1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
| 1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
| Find all providers in zip 97239 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417041989 | Richard J Konkol | Psychiatry & Neurology | 3550 North Interstate Ave, Medical Office East, Portland, OR 97227-1097 | 2006-10-02 |
| 1689093817 | Artur Riddle | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3079 | 2014-04-15 |
| 1033535463 | Providence Health & Services - Oregon | Psychiatry & Neurology | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2014-03-10 |
| 1689017048 | Ittai Bushlin | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2013-04-16 |
| 1851633077 | Joshua J Kim | Psychiatry & Neurology | 9427 Sw Barnes Rd Ste 395, Portland, OR 97225-6652 | 2013-03-26 |
| 1639436074 | Alison Christy | Psychiatry & Neurology | 9427 Sw Barnes Rd, Suite 395, Portland, OR 97225-6652 | 2012-04-23 |
| 1487709259 | Erika Lee Finanger | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd, Cdrc-p, Portland, OR 97239-3011 | 2007-01-24 |
| 1386796266 | Jennifer Clare Huffman | Psychiatry & Neurology | 501 N Graham St, Suite 330a, Portland, OR 97227-1654 | 2007-01-18 |
| 1295743722 | Colin Matthew Roberts | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2006-08-03 |
| 1356358287 | Stephen Arthur Back | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2006-08-02 |
| Find all providers in PORTLAND | ||||
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| 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.