Dale Burton Mortimer, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD00028371 Issued in WA

Practice address

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

Phone

(360) 882-9058

Fax

(360) 567-0861

NPI assigned

Oct 15, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 20, 2015 through Nov 20, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dale B Mortimer MD PC

  • Child & Adolescent Psychiatry Physician
  • Vancouver, WA
  • NPI 1023200813
  NPD (past) Authorized official

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224028800000",
    "number": "1467604025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": {
        "last_name": "MORTIMER",
        "first_name": "DALE",
        "middle_name": "BURTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-15",
        "last_updated": "2008-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD00028371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larissa Faye Morrow, PHARMD
• Miki Morrow, LMT
• Patricia K Mortell
• Brittni L Mortensen, NNP-BC
• Greggory Mortensen, DPT
• Julia Mortlock, ND, LAC
• Paul David Mortlock, PA-C
• Andrea Morton, O.D.
• Catherine Elizabeth Morton, M.A./M.C.
• Marla E Morton, M.A.

• 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 Oct 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.