Individual
MARCIA BERTALOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2701 NW VAUGHN ST, PORTLAND, OR 97210-5311
(503) 499-5200
Mailing address
3633 NW 163RD TER, BEAVERTON, OR 97006-7245
(503) 645-1517
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
096006178N3
OR
363LA2200X
Adult Health Nurse Practitioner
AP30004275
WA
Other
Enumeration date
08/25/2006
Last updated
09/28/2020
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