Healthcare Provider Details

I. General information

NPI: 1740735166
Provider Name (Legal Business Name): CHRISTINA BERNARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 NW 27TH ST
CORVALLIS OR
97330-5223
US

IV. Provider business mailing address

610 DRAGON DR
MONROE OR
97456-9604
US

V. Phone/Fax

Practice location:
  • Phone: 541-766-6835
  • Fax: 541-766-6186
Mailing address:
  • Phone: 541-847-5143
  • Fax: 541-847-5144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: