Leatherwood, Amy Eiko Bernel

Leatherwood, Amy Eiko Bernel is an individual health care provider with primary practice located at 3303 Sw Bond Ave. , Portland OR 97239. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Leatherwood, Amy Eiko Bernel can be contacted via phone (503) 346-1500.

Contact Information

Primary practice address
3303 Sw Bond Ave. Portland OR 97239
Phone: (503) 346-1500
Fax: (503) 346-1501
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 200350011NP Oregon
Nursing Service Providers / Registered Nurse 163W00000X 200340159RN Oregon

Profile Details

NPI number 1386636736
LBN Legal business name Leatherwood, Amy Eiko Bernel
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Jun 12th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386636736 NPPES
Washington MEDICAID 9641440
Washington MEDICAID 022498

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