Individual
MARCUS BERGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1001 PROVIDENCE WAY, NEWBERG, OR 97132
(503) 537-1796
Mailing address
2205 SW 21ST AVE, PORTLAND, OR 97201-2358
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
OR
Other
Enumeration date
06/19/2007
Last updated
07/08/2007
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