Provider Demographics
NPI:1497520555
Name:BERKA, ANNA MARIA (NP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:BERKA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 SW MARICARA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-6905
Mailing Address - Country:US
Mailing Address - Phone:971-336-3388
Mailing Address - Fax:
Practice Address - Street 1:3105 SW MARICARA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-6905
Practice Address - Country:US
Practice Address - Phone:971-336-3388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10018664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily