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General NPI Number Information
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NPI Number | 1902528201
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Entity Type | Individual
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Provider Name | STACEY L BERN MPH
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Gender | Female
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 100 E 33RD ST STE 201A
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City | VANCOUVER
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State | WA
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Zip | 98663-2776
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Country | US
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Telephone | 360-986-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 SE 7TH AVE
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City | CAMAS
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State | WA
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Zip | 98607-2216
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Country | US
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Telephone | 503-476-4464
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Fax |
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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