Berry, Tracey I.
Berry, Tracey I. is an individual health care provider with primary practice located at 120 Nw 14Th Ave Suite 300, Portland OR 97209-2601. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Berry, Tracey I. can be contacted via phone (503) 299-9906.Contact Information
Primary practice address
120 Nw 14Th Ave Suite 300
Portland OR 97209-2601
Phone: (503) 299-9906
Fax: (503) 225-9002
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | MD19311 | Oregon |
Profile Details
| NPI number | 1366416570 |
|---|---|
| LBN Legal business name | Berry, Tracey I. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 14th, 2006 |
| Last updated | Feb 22nd, 2008 - about 16 years ago |
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 | 1366416570 | NPPES |
| Washington | MEDICAID | 8271785 | |
| Washington | MEDICAID | 076989 | |
| Washington | Other | P00059037 |
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