Active NPI
Dale Hitchcock
- Adult Psychiatric/Mental Health Registered Nurse
- Woodburn, OR
National Provider Identifier
1770780983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Registered Nurse
- Practice address
- 1605 East Lincoln Rd.
Woodburn, OR 97071-5534 - Phone
- (503) 982-9300
- NPI assigned
- Jun 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | OR | Primary |
Addresses
Primary practice location
1605 East Lincoln Rd.
Woodburn, OR 97071-5534
Mailing address
325 Brandywine CT
Woodburn, OR 97071-5534
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 087003109RN | OR | MD | Adult Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770780983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 BRANDYWINE CT",
"city": "WOODBURN",
"state": "OR",
"postal_code": "970715534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 EAST LINCOLN RD.",
"city": "WOODBURN",
"state": "OR",
"postal_code": "970715534",
"telephone_number": "503-982-9300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HITCHCOCK",
"first_name": "DALE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0809X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodburn, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.