Individual
AMY E BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
620 NE 2ND ST, GRESHAM, OR 97030-7514
(971) 274-3757
(503) 912-5740
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200540554RN
OR
163W00000X
Registered Nurse
RN60333379
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201506290NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP61012022
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500715774
—
OR
Enumeration date
09/14/2015
Last updated
11/13/2023
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