MR. MARK LAWRENCE PIETROK (NPI# 1861580540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1861580540 |
Entity Type | Individual |
Full Name | MR. MARK LAWRENCE PIETROK |
Credential | A.T.C. |
Practice Address |
0615 Sw Palatine Hill Rd Portland OR 97219-7879 |
Mailing Address |
11149 Sw Matzen Dr Wilsonville OR 97070-8574 |
Practice Telephone | 5037687065 |
Practice Fax Number | 5037687058 |
Mailing Telephone | 5036821622 |
Enumeration Date | 2006-10-10 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT-AT-125479 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
0615 SW PALATINE HILL RD |
City | PORTLAND |
State | OR |
Zip Code | 97219-7879 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851841019 | Natalia Mccaskill | Marriage & Family Therapist | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2016-10-11 |
1801291745 | Tara Boatman | Specialist/Technologist | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2014-11-04 |
1245426493 | Elizabeth Ratcliff Austin | Nurse Practitioner | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2007-09-21 |
1750571618 | Justin Leak | Marriage & Family Therapist | 0615 Sw Palatine Hill Rd, Msc 101, Portland, OR 97219-7879 | 2007-07-26 |
1184745929 | Julie Carol Radostitz | Internal Medicine | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2007-04-02 |
1174647390 | Ann Marie Whiting | Nurse Practitioner | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2007-03-16 |
1790809812 | Nancy Jane Kalvelage | Nurse Practitioner | 0615 Sw Palatine Hill Rd, Portland, OR 97219-7879 | 2007-03-16 |
1114073574 | Kara Powers | Psychiatry & Neurology | 0615 Sw Palatine Hill Rd, Lewis and Clark College Counselling Center, Portland, OR 97219-4959 | 2007-01-26 |
1942365671 | John E Hancock | Psychologist | 0615 Sw Palatine Hill Rd, Lewis and Clark College Msc 135, Portland, OR 97219-7879 | 2006-12-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356958672 | Lighthouse Psychological Services, LLC | Psychologist | 630 Sw Nevada St, Ste. E, Poralnd, OR 97219 | 2020-09-30 |
1083130991 | Tawayne Nolen Malone Jr. | Psychologist | 0615 Sw Palatine Hill Road, Tawayne Malone - Msc 2159, Portland, OR 97219 | 2017-08-22 |
1548667918 | Eleven Eleven, LLC | Specialist/Technologist, Other | 6714 Sw 62nd Place, Portland, OR 97219 | 2014-12-01 |
1023414257 | Paul Shayne Hansen | Adult Companion | 9155 Sw 55th Avenue, Portland, OR 97219 | 2014-11-17 |
1154721850 | Mikhail Govshievich | Denturist | 9045 Sw Barbur Blvd. Suit 117, Portland, OR 97219 | 2014-08-29 |
1255749404 | Kristin Rae Paruszkiewicz | Physical Therapist | 7943 Sw Barbur Blvd #1, Portland, OR 97219 | 2014-07-31 |
1639436488 | Michelle Lorraine Emery | Counselor | 7912 Sw 35th, Portland, OR 97219 | 2012-04-18 |
1588930192 | Steve Ryan | Speech-Language Pathologist | 3315 Sw Falcon St, Portland, OR 97219 | 2012-03-28 |
1104145952 | Multnomah Family Care Center | Clinic/Center | 6787 Sw Capitol Hwy, Portland, OR 97219 | 2010-05-19 |
1740518331 | Trilbie L Patteson | Physical Therapy Assistant | 5701 Sw Multnomah Boulevard, West Hills Health and Rehab, Portland, OR 97219 | 2009-11-20 |
Find all providers in zip 97219 |
Taxonomy Code | 2255A2300X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Specialist/Technologist |
Specialization | Athletic Trainer |
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
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1639782550 | Madeleine Vivian Reid | Specialist/Technologist | 204 Maine Ave, Portland, ME 04103-3906 | 2020-08-29 |
1154933158 | Jennifer Owens | Specialist/Technologist | 2 Jobs Gate 1, Portland, CT 06480-1750 | 2020-08-20 |
1083232847 | Bailey Michelle Allen | Specialist/Technologist | 3521 Ne 154th Ave, Portland, OR 97230-4677 | 2020-07-08 |
1568097061 | Rob Gersky | Specialist/Technologist | 2712 Se 170th Ave, Portland, OR 97236-1215 | 2020-03-05 |
1922630037 | Vanessa A Guerrero | Specialist/Technologist | 2219 Se 68th Ave # 410, Portland, OR 97215-4026 | 2020-02-06 |
1386284453 | Richard J Campbell | Specialist/Technologist | 300 N Winning Way, Portland, OR 97227-2108 | 2020-01-07 |
1417597584 | Sarah Ashley Mcsweeney | Specialist/Technologist | 2105 Nw Flanders St Apt 4, Portland, OR 97210-3450 | 2020-01-07 |
1629617402 | Roger A Doak | Specialist/Technologist | 1100 Ionia Rd, Portland, MI 48875-1035 | 2019-12-27 |
1366096448 | Madeleine Knutson | Specialist/Technologist | 12617 Nw Avignon Ln, Portland, OR 97229-9405 | 2019-07-28 |
1720648215 | Nicholas Ryan Thomas | Specialist/Technologist | 4800 Ne 122nd Ave, Portland, OR 97230-1001 | 2019-06-17 |
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.