Individual
MIRRA LEAH NERENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDM,CPM, DEM
Contact information
Practice address
1016 SE 12TH AVE, PORTLAND, OR 97214
(503) 432-7379
(971) 228-1387
Mailing address
3927 SE 64TH AVE, PORTLAND, OR 97206
(503) 432-7379
(917) 228-1387
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
DEM-LD-10140879
OR
Other
Enumeration date
05/05/2011
Last updated
11/09/2017
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