Provider Demographics
NPI:1922367044
Name:KLARBERG, DAVID J (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:KLARBERG
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 SE 91ST AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-3762
Mailing Address - Country:US
Mailing Address - Phone:832-548-5076
Mailing Address - Fax:503-775-2275
Practice Address - Street 1:9300 SE 91ST AVE STE 400
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-3762
Practice Address - Country:US
Practice Address - Phone:503-775-6500
Practice Address - Fax:503-775-2275
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20180868NP-PP363LF0000X
TX816544363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500757516Medicaid
TX080462703Medicaid