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Individual

MR. DAVID MARK VITELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGPCNP

Contact information

Practice address
3303 SW BOND AVE, PORTLAND, OR 97239-4501
(503) 418-7246
Mailing address
PO BOX 22075, MILWAUKIE, OR 97269-2075
(503) 353-1272

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC175336
OR
363LA2100X
Acute Care Nurse Practitioner
Primary
201507396NP-PP
OR

Other

Enumeration date
02/12/2007
Last updated
04/16/2020
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