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General NPI Number Information
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NPI Number | 1730518754
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Entity Type | Organization
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Legal Business Name | REBECCA BERZOW ND
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 15455 NW GREENBRIER PKWY STE 100
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City | BEAVERTON
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State | OR
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Zip | 97006-7357
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Country | US
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Telephone | 971-231-4372
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Fax | 971-277-6027
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Provider Business Mailing Address
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Address Line | 15455 NW GREENBRIER PKWY STE 100
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City | BEAVERTON
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State | OR
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Zip | 97006-7357
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Country | US
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Telephone | 971-231-4372
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Fax | 971-277-6027
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Authorized Official
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Title or Position | DOCTOR
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Name | REBECCA BERZOW
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Credential | ND
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Telephone | 971-231-4372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 1871
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License Number State | OR
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