Heather Grace Depolitte, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

201042698RN Issued in OR

Practice address

313 NE Ivy St
Portland, OR 97212-2089

Phone

(503) 232-1099

NPI assigned

Jun 12, 2011

Last updated

May 31, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Heather Grace Pardun Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1307836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1942595517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 NE IVY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122089",
            "telephone_number": "503-236-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 NE IVY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122089",
            "telephone_number": "503-232-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPOLITTE",
        "first_name": "HEATHER",
        "middle_name": "GRACE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-12",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201042698RN",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "201042698RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "PARDUN",
            "middle_name": "GRACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Luke Depner, OTR/L
• David Allen Deppeler, PT
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• Lauren Ann Dequasie
• Erin Deramus
• Gabriella Deras

• Registered Nurse in Portland, OR
• Providers in Portland, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; 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.