Berry, Jonathan Dale
Berry, Jonathan Dale is an individual health care provider with primary practice located at 2330 Heritage Way Se , Albany OR 97322-8600. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Berry, Jonathan Dale can be contacted via phone (541) 926-6077.Contact Information
Primary practice address
2330 Heritage Way Se
Albany OR 97322-8600
Phone: (541) 926-6077
Fax: (541) 926-0605
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ATI3122 | Oregon |
Profile Details
| NPI number | 1427027754 |
|---|---|
| LBN Legal business name | Berry, Jonathan Dale |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 17th, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427027754 | NPPES |
| Oregon | MEDICAID | 270040 | |
| Oregon | Other | 009446008 |
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