Individual
ELIZABETH MARIE BERKLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD # UHN73A, PORTLAND, OR 97239-3011
(630) 276-8821
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601007404
MI
Other
Enumeration date
10/14/2014
Last updated
05/31/2017
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