Organization
EAST PORTLAND MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERTRAM BERNEY MD (OWNER)
(503) 230-4811
Entity
Organization
Contact information
Practice address
7524 SE MILWAUKIE AVE, PORTLAND, OR 97202-6113
(503) 230-4811
(503) 249-1872
Mailing address
7524 SE MILWAUKIE AVE, PORTLAND, OR 97202-6113
(503) 230-4811
(503) 249-1872
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD16449
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110398
MEDICARE GRP PROVIDER #
OR
Enumeration date
01/29/2008
Last updated
12/19/2018
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