Dale B Mortimer MD PC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD00028371 Issued in WA

Legal business name

DALE B MORTIMER MD PC

Practice address

10000 NE 7TH Ave
Suite 385
Vancouver, WA 98685-2955

Phone

(360) 882-9058

Fax

(360) 567-0861

NPI assigned

Aug 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dale Burton Mortimer, MDNPI 1467604025

Title

Chairman and President

Phone

(360) 882-9058

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dale Burton Mortimer, M.D.

  • Child & Adolescent Psychiatry Physician
  • Vancouver, WA
  • NPI 1467604025
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187136000000",
    "number": "1023200813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 NE TENNEY ROAD",
            "address_2": "PMB 110 232",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986852831",
            "telephone_number": "360-882-9058",
            "fax_number": "360-567-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 NE 7TH AVE",
            "address_2": "SUITE 385",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986852955",
            "telephone_number": "360-882-9058",
            "fax_number": "360-567-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE B MORTIMER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A",
        "authorized_official_last_name": "MORTIMER",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "BURTON",
        "authorized_official_title_or_position": "CHAIRMAN AND PRESIDENT",
        "authorized_official_telephone_number": "360-882-9058",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD00028371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Lynn Dailey, M.D.
• Lissa C Daimaru-Enoki, M.D.
• Stephanie Dakanno
• Jennifer Dalal, PA-C
• Danielle Dalbok
• Liam Dale
• Katie Dalgamouni, DO
• Dallas R. Frantz DDS, PLLC
• Paul D Dally, MD
• Brianna Dalton, MHP, CG

• Child & Adolescent Psychiatry Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Child & Adolescent Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.