Individual
ALICE BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.E.
Contact information
Practice address
1500 NW BETHANY BLVD, SUITE 200, BEAVERTON, OR 97006-5208
(503) 597-1323
Mailing address
1500 NW BETHANY BLVD, SUITE 200, BEAVERTON, OR 97006-5208
(503) 597-1323
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
BAP-E-10167109
OR
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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