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NPI 1326834045

NPI 1326834045 : ELVIRA BERTRAND : PORTLAND, OR

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General NPI Number Information
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    NPI Number           |    1326834045
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    Entity Type          |    Individual 
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    Provider Name        |    ELVIRA BERTRAND
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/18/2025
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    Last Update Date     |    04/18/2025
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Provider Practice Location Address
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    Address Line         |    1515 NW 23RD AVE 
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    City                 |    PORTLAND
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    State                |    OR
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    Zip                  |    97210-2617
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    Country              |    US
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    Telephone            |    503-741-9951
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1515 NW 23RD AVE 
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    City                 |    PORTLAND
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    State                |    OR
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    Zip                  |    97210-2617
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    Country              |    US
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    Telephone            |    503-741-9951
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    Fax                  |    503-974-0953
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    221700000X
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    Taxonomy Name        |    Art Therapist
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    License Number       |    
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    License Number State |    
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