Individual
MARY BERENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6003 SE 136TH AVE, PORTLAND, OR 97236-4567
(503) 954-2119
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/10/2009
Last updated
08/10/2009
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