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ETHAN JAMES VANDEMARK MD
NPI 1205623386
Student in an Organized Health Care Education/Training Program in Tucson, AZ

Active since April 22, 2025
839 W CONGRESS ST, TUCSON, AZ 85745(520) 738-3702 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Ethan James Vandemark Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN JAMES VANDEMARK MD (NPI 1205623386) is an individual student in an organized health care education/training program in Tucson, Arizona and active in the NPI registry since April 2025.

NPPES Registry Identity

NPI1205623386
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameETHAN JAMES VANDEMARKCredential: MD
Location Address839 W CONGRESS STTucson, AZ 85745-2819
Mailing Address839 W Congress StTucson, AZ 85745-2819
Phone(520) 738-3702
Sole ProprietorNo
Enumeration DateApril 22, 2025
NPPES CertifiedApril 22, 2025
✔ NPI 1205623386 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
839 W CONGRESS ST, Tucson, AZ 85745
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLA FINLEY MD
Internal Medicine
839 W CONGRESS ST
TUCSON, AZ 85745
Pima County (520) 792-9890
MRS. LINDA GAIL NADLER CHAMBERLAIN OPTICIAN
Technician/Technologist (Optician)
839 W CONGRESS ST
TUCSON, AZ 85745
Pima County (520) 620-6709
CRISTINA MONTIEL
Dental Hygienist
839 W CONGRESS ST
TUCSON, AZ 85745
Pima County (520) 670-3909
SHAWN LEE
Dental Hygienist
839 W CONGRESS ST
TUCSON, AZ 85745
Pima County (520) 670-3909
JANICE RODENBERG CNM
Advanced Practice Midwife
839 W CONGRESS ST
TUCSON, AZ 85745
Pima County (520) 670-3870
GABRIELLE OCHOA MD
Internal Medicine
839 W CONGRESS ST
TUCSON, AZ 85745
Pima County (520) 670-3909
DR. DANIEL JOSEPH CAPPOZZO D.C.
Chiropractor
839 W CONGRESS ST
TUCSON, AZ 85745
Pima County (520) 670-3909
MR. HERMAN DAVID VERDUGO RPH
Pharmacist
839 W CONGRESS ST
TUCSON, AZ 85745
Pima County (520) 205-4996

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Vandemark's NPI number?

The NPI number for Ethan Vandemark is 1205623386. It was assigned to this individual provider in the NPPES registry on April 22, 2025.

Where is Ethan Vandemark located?

Ethan Vandemark practices at 839 W Congress St, Tucson, AZ 85745. The listed phone number is (520) 738-3702.

What is Ethan Vandemark's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Ethan Vandemark was last updated on April 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.