Healthcare Provider Details

I. General information

NPI: 1316927916
Provider Name (Legal Business Name): ANNE MARIE BARRY-LEVER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

178 SW 2ND AVE
CANBY OR
97013-4152
US

IV. Provider business mailing address

6619 S ZIMMERMAN RD
AURORA OR
97002-9302
US

V. Phone/Fax

Practice location:
  • Phone: 503-416-4547
  • Fax: 503-416-4555
Mailing address:
  • Phone: 503-651-3214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number087000095N3
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: