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General NPI Number Information
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NPI Number | 1851731251
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Entity Type | Individual
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Provider Name | LANDON BERGER PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 6125 NE CORNELL RD STE 290
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City | HILLSBORO
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State | OR
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Zip | 97124-5417
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Country | US
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Telephone | 503-389-5473
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Fax |
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Provider Business Mailing Address
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Address Line | 2365 NW IRVING ST APT 8
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City | PORTLAND
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State | OR
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Zip | 97210-3392
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Country | US
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Telephone | 503-209-9218
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Fax | 503-372-5843
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2255
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License Number State | OR
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