Individual
AMY EIKO BERNEL LEATHERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3303 SW BOND AVE., PORTLAND, OR 97239
(503) 346-1500
(503) 346-1501
Mailing address
3303 SW BOND AVE. CH10U, PORTLAND, OR 97239
(503) 346-1500
(503) 346-1501
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200340159RN
OR
363LF0000X
Family Nurse Practitioner
Primary
200350011NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022498
—
OR
05
—
9641440
—
WA
Enumeration date
08/19/2005
Last updated
06/12/2012
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