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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MS. DOMINIQUE R WILSON DNP, PMHNP, FNP
NPI 1295019909
Nurse Practitioner - Psychiatric/Mental Health in Portland, OR

Active since September 30, 2011PECOS EnrolledAccepts Medicare Assignment
205 SE SPOKANE ST STE 300, PORTLAND, OR 97202(855) 704-2004(503) 386-3366 Get Directions Write a Review

NPPES record last updated: October 4, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 4, 2026, May 1, 2024, Jul 21, 2023 and 4 more (7 updates tracked since 2021).

About Ms. Dominique R Wilson Dnp, Pmhnp, Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. DOMINIQUE R WILSON DNP, PMHNP, FNP (NPI 1295019909) is an individual psychiatric/mental health provider in Portland, Oregon, licensed in Oregon (202100794NP) and active in the NPI registry since September 2011. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1295019909
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMS. DOMINIQUE R WILSONCredential: DNP, PMHNP, FNP
Location Address205 SE SPOKANE ST STE 300Portland, OR 97202-6487
Mailing Address205 Se Spokane St Ste 300Portland, OR 97202-6487 · (855) 704-2004 · Fax (503) 386-3366
Phone(855) 704-2004
Fax(503) 386-3366
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateSeptember 30, 2011
Last NPPES UpdateOctober 4, 20267 updates tracked since enumeration
NPPES CertifiedOctober 4, 2026
✔ NPI 1295019909 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in OR · 202100794NP✔ Licensed in WA · AP61131624✔ Licensed in TX · AP119115
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License AP119115 (TX), 202100794NPPP (OR)
205 SE SPOKANE ST STE 300, Portland, OR 97202
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1401 Broadway Ste 100Tacoma, WA 98402-3900 · Phone (855) 704-2004 · Fax (503) 386-3366
Location 22000 E LaMar Blvd Ste 600Arlington, TX 76006-7361 · Phone (855) 704-2004 · Fax (503) 386-3366

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Blue Cross and Blue Shield of Texas, BridgeSpan Health Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Dominique R Wilson Dnp, Pmhnp, Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133380223
PECOS Enrollment IDI20210422002882
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

5

Medicare enrollment records show Dominique Wilson reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Relief Mental Health Consultants PLLC
Same address
Psychiatric/Mental Health
205 SE SPOKANE ST STE 300
Portland, OR 97202
  • Reassigned Medicare billing, Oregon enrollment
NPI 1538784004 (855) 704-2004
Mindful Therapy Group PC
162 mi
Clinical
6505 216TH ST SW STE 100
Mountlake Terrace, WA 98043
  • Reassigned Medicare billing, Washington enrollment
  • 777 clinicians in this Medicare group
NPI 1316238678 (425) 640-7009
Dfw Psychiatry Associates PA
1,617 mi
Psychiatry
4500 HILLCREST RD, SUITE 115
Frisco, TX 75035
  • Reassigned Medicare billing, Texas enrollment
  • 6 clinicians in this Medicare group
NPI 1932539210 (469) 213-6400
Hawkins Psychiatry PC
1,619 mi
Psychiatry
920 W MITCHELL ST
Arlington, TX 76013
  • Reassigned Medicare billing, Texas enrollment
  • 14 clinicians in this Medicare group
NPI 1003056607 (817) 460-7080
Adult Child & Adolescent Psychiatric Services PA
1,621 mi
Psychiatry
5501 INDEPENDENCE PKWY STE 302
Plano, TX 75023
  • Reassigned Medicare billing, Texas enrollment
  • 11 clinicians in this Medicare group
NPI 1194036459 (469) 747-1010

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97202 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEIDI STACHELRODT LMT
Massage Therapist
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (503) 866-9271
CULTIVATING A NEW LIFE LLC
Social Worker (Clinical)
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (541) 904-0468
NATHAN DAVIS LICENSED MARRIAGE &
Marriage & Family Therapist
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (971) 777-8929
CBT PORTLAND LLC
Psychologist
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (503) 395-2143
MOONLIGHT THERAPIES LLC
Massage Therapist
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (971) 772-8322
JASON MATTHEW NICHOLS
Nurse Practitioner (Psychiatric/Mental Health)
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (503) 744-7186
CELESTE ARNOLD
Nurse Practitioner (Psychiatric/Mental Health)
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (503) 744-7186
DR. MAYA M WILLIAMS PHD
Psychologist (Counseling)
205 SE SPOKANE ST STE 300
PORTLAND, OR 97202
Multnomah County (503) 877-0711

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dominique Wilson's NPI number?

The NPI number for Dominique Wilson is 1295019909. It was assigned to this individual provider in the NPPES registry on September 30, 2011.

Where is Dominique Wilson located?

Dominique Wilson practices at 205 SE Spokane St Ste 300, Portland, OR 97202. The listed phone number is (855) 704-2004.

What is Dominique Wilson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Dominique Wilson enrolled in Medicare?

Yes. Dominique Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Dominique Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dominique Wilson reassigns Medicare benefits to 5 organizations: Relief Mental Health Consultants PLLC (Portland, OR), Mindful Therapy Group PC (Mountlake Terrace, WA), Dfw Psychiatry Associates PA (Frisco, TX), Hawkins Psychiatry PC (Arlington, TX) and Adult Child & Adolescent Psychiatric Services PA (Plano, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dominique Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dominique Wilson accept?

Health plans from Ambetter Health, Blue Cross and Blue Shield of Texas, BridgeSpan Health Company, Cigna Healthcare and Kaiser Permanente and 6 other insurers list Dominique Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dominique Wilson was last updated on October 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 35 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.