Provider Demographics
NPI:1609576719
Name:BERRY, HANNAH BECK
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:BECK
Last Name:BERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BECK
Other - Middle Name:
Other - Last Name:MARGOLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2816 SE 133RD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-3027
Mailing Address - Country:US
Mailing Address - Phone:310-405-5492
Mailing Address - Fax:
Practice Address - Street 1:422 SE 79TH AVE # 202
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1519
Practice Address - Country:US
Practice Address - Phone:971-910-8918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health