MR. DAVID MARK VITELLO (NPI# 1811038755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811038755 |
| Entity Type | Individual |
| Full Name | MR. DAVID MARK VITELLO |
| Credential | AGPCNP |
| Practice Address |
3303 Sw Bond Ave Portland OR 97239-4501 |
| Mailing Address |
Po Box 22075 Milwaukie OR 97269-2075 |
| Practice Telephone | 5034187246 |
| Mailing Telephone | 5033531272 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-04-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171100000X | Acupuncturist | AC175336 | OR | Other Service Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
201507396NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3303 SW BOND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639174287 | Dawn F. Tilgner | Nurse Practitioner | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2005-06-19 |
| 1376164582 | Marisa Palandri | Occupational Therapist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2020-04-28 |
| 1194345629 | Margaret Alva Mcreynolds | Physical Therapist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2020-04-24 |
| 1104446392 | Jennifer Crawford | Occupational Therapist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2020-04-17 |
| 1093335275 | Mehak Noorani | Speech-Language Pathologist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2020-04-17 |
| 1497374185 | Ruth Semon | Physical Therapist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2020-04-13 |
| 1649899675 | Kristin Moore | Physical Therapist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2020-04-09 |
| 1821627266 | Mollie Ann Suits | Physical Therapist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2020-04-07 |
| 1801425269 | Andrea Susan Serdar | Physical Therapist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2020-04-06 |
| 1508495037 | Chante Noel Larlee | Physical Therapist | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2020-04-06 |
| 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 | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588136295 | Tao Wang | Nurse Practitioner | 38 Michele Dr, Portland, CT 06480-1013 | 2018-12-19 |
| 1679041115 | Kendra Kathryn Mundstock | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd # 13k, Portland, OR 97239-3011 | 2018-11-02 |
| 1043786551 | Lindsey Forleo | Nurse Practitioner | 22 Bramhall St Rm 4670, Portland, ME 04102-3134 | 2018-10-23 |
| 1659801785 | Christine Haboush | Nurse Practitioner | 6015 Ne Skidmore St, Portland, OR 97218-2225 | 2017-06-12 |
| 1386042315 | Jessica Mayer | Nurse Practitioner | 122 Se 80th Ave, Portland, OR 97215-1522 | 2014-12-08 |
| 1376814095 | Paula Claire Havelin | Nurse Practitioner | 235 Highway 52 W, Portland, TN 37148-1407 | 2012-01-26 |
| 1417284175 | Derek Neil Bowers | Nurse Practitioner | 2836 Ne Bryce St, Portland, OR 97212-1640 | 2009-11-17 |
| 1982820692 | Hilary Anne Shreves | Nurse Practitioner | 3303 Sw Bond Ave Ste 10, Portland, OR 97239-4501 | 2007-04-18 |
| 1588691117 | Emily Tidwell | Nurse Practitioner | 421 N Broadway, Portland, TN 37148-1750 | 2006-06-27 |
| 1639174287 | Dawn F. Tilgner | Nurse Practitioner | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2005-06-19 |
| 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.