Individual
AUDRA K BERNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2122 NW QUIMBY, ROOT WHOLE BODY, PORTLAND, OR 97210
(503) 292-7668
Mailing address
3035 NE MARTIN LUTHER KING JR BLVD APT 203, PORTLAND, OR 97212-3094
(505) 819-8305
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22556
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22556
BOARD OF MASSAGE THERAPISTS
OR
Enumeration date
07/21/2017
Last updated
07/21/2017
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