Individual
DEZIRAE E BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1119 HIGHLAND AVE, CLARKSTON, WA 99403-2836
(509) 769-2269
(509) 769-2270
Mailing address
1522 17TH ST, LEWISTON, ID 83501-3652
(208) 743-8416
(208) 743-4642
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
55464
ID
363LF0000X
Family Nurse Practitioner
Primary
55464
ID
363LF0000X
Family Nurse Practitioner
N361446320
WA
Other
Enumeration date
01/09/2023
Last updated
10/08/2025
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