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Individual

ANGELIQUE MARIE BERENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2901 174TH ST NE, MARYSVILLE, WA 98271-4743
(604) 541-9413
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(360) 454-1941

Taxonomy

Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
A154468
CA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
MD60685509
WA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/27/2012
Last updated
11/19/2021
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