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Organization

VALUECORE MENTAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN BERG (BUSINESS MANAGER)
(503) 266-1407
Entity
Organization

Contact information

Practice address
409 NW 2ND AVE STE B, CANBY, OR 97013-3517
(503) 266-1407
Mailing address
409 NW 2ND AVE STE B, CANBY, OR 97013-3517

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1831216779
INDIVIDUAL NPI
OR
Enumeration date
06/08/2022
Last updated
06/08/2022
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