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Individual

DR. JONATHAN DALE BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2330 HERITAGE WAY SE, ALBANY, OR 97322-8600
(541) 926-6077
(541) 926-0605
Mailing address
2330 HERITAGE WAY SE, ALBANY, OR 97322-8600
(541) 926-6077
(541) 926-0605

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ATI3122
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009446008
REGENCE BC BS
OR
05
270040
OR
Enumeration date
03/17/2006
Last updated
03/07/2023
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