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Individual

MIKE DOUGLAS BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
888 SWIFT BLVD, RICHLAND, WA 99352-3514
(509) 946-4611
Mailing address
505 S 336TH ST STE 350, FEDERAL WAY, WA 98003-5948
(253) 733-3969

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
177890
MT
363L00000X
Nurse Practitioner
Primary
AP60610441
WA

Other

Enumeration date
03/14/2016
Last updated
07/17/2024
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