De La Bruere, Beverly Ann
De La Bruere, Beverly Ann is an sole proprietor health care provider with primary practice located at 18151 Se Highway 212 , Damascus OR 97089-8764. She recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as her primary health care specialty. De La Bruere, Beverly Ann can be contacted via phone (503) 658-6022.Contact Information
Primary practice address
18151 Se Highway 212
Damascus OR 97089-8764
Phone: (503) 658-6022
Fax: (503) 658-7818
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | MD15031 | Oregon |
Profile Details
| NPI number | 1720176332 |
|---|---|
| LBN Legal business name | De La Bruere, Beverly Ann |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 10th, 2006 |
| Last updated | Aug 2nd, 2012 - about 12 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 | 1720176332 | NPPES |
| Oregon | MEDICAID | 110403 |
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