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General NPI Number Information
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NPI Number | 1962800789
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Entity Type | Individual
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Provider Name | AMANDA BERNAL LMFT
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Gender | Female
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Dates
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Enumeration Date | 12/10/2014
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Last Update Date | 12/26/2023
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Provider Practice Location Address
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Address Line | 5 CENTERPOINTE DR STE 320
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-8696
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Country | US
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Telephone | 971-400-7787
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Fax | 971-209-7260
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Provider Business Mailing Address
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Address Line | 5 CENTERPOINTE DR STE 320
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-8696
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Country | US
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Telephone | 971-400-7787
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Fax | 971-209-7260
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T1575
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License Number State | OR
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