Healthcare Provider Details

I. General information

NPI: 1427693365
Provider Name (Legal Business Name): VERONICA BERRI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2019
Last Update Date: 11/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13175 SE KUEHN RD
MILWAUKIE OR
97222-4730
US

IV. Provider business mailing address

13175 SE KUEHN RD
MILWAUKIE OR
97222-4730
US

V. Phone/Fax

Practice location:
  • Phone: 319-400-2495
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: