Individual
DR. WILLIAM BERT BERK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
13180 SE 169TH AVE STE 104, HAPPY VALLEY, OR 97086
(503) 698-2375
(503) 698-3398
Mailing address
13180 SE 169TH AVE STE 104, HAPPY VALLEY, OR 97086-8727
(503) 698-2375
(503) 698-3398
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1623ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508037607
ORGANIZATION (GROUP) NPI
—
01
—
R0000WDBCW
MEDICARE GROUP PIN
—
Enumeration date
09/17/2006
Last updated
08/14/2018
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