DR. KELLY WITBECK DNP ARNP NPI 1366812380

NPI Information

NPI: 1366812380
Provider Name: DR. KELLY WITBECK, DNP, ARNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
833 SW 11TH AVE STE 915
PORTLAND, OR
ZIP 97205
Phone: (971) 366-2315
Get Directions

DR. Kelly Witbeck, DNP, ARNP is a psychiatric/mental health nurse practitioner in Portland, OR. DR. Kelly Witbeck, DNP, ARNP NPI is 1366812380. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

833 SW 11TH AVE STE 915
PORTLAND, OR
ZIP 97205-123
Phone: (971) 366-2315
Fax: (360) 245-9181

The NPI 1366812380 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/2/2015 and was last updated on 2/3/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	201507845NP-PP	OREGON	No
2	363LF0000X	Nurse Practitioner	Family	AP60787605	WASHINGTON	No
3	363LF0000X	Nurse Practitioner	Family	9277250	FLORIDA	No
4	363LF0000X	Nurse Practitioner	Family	NUR-APRN-LIC-170570	MONTANA	No
5	363LF0000X	Nurse Practitioner	Family	167743	ALASKA	No
6	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	9277250	FLORIDA	No
7	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	NUR-APRN-LIC-170570	MONTANA	No
8	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	167743	ALASKA	No
9	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AP60787605	WASHINGTON	No
10	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	201507845NP-PP	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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