Provider Demographics
NPI:1003173600
Name:MITSCH, APRIL D (RD)
Entity Type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:D
Last Name:MITSCH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:C
Other - Last Name:DAYTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:18814 NE COLE WITTER RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-7656
Mailing Address - Country:US
Mailing Address - Phone:360-666-3519
Mailing Address - Fax:
Practice Address - Street 1:700 SW CAMPUS DR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3107
Practice Address - Country:US
Practice Address - Phone:503-494-8362
Practice Address - Fax:503-494-4447
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10152488133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered