Provider Demographics
NPI:1952362881
Name:SPERLEY, BERNIE P (DO)
Entity Type:Individual
Prefix:DR
First Name:BERNIE
Middle Name:P
Last Name:SPERLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2801 N GANTENBEIN AVE
Mailing Address - Street 2:ICU EAST - EMANUEL HOSPITAL
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1623
Mailing Address - Country:US
Mailing Address - Phone:503-413-2200
Mailing Address - Fax:503-413-1119
Practice Address - Street 1:2801 N GANTENBEIN AVE
Practice Address - Street 2:ICU EAST - EMANUEL HOSPITAL
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1623
Practice Address - Country:US
Practice Address - Phone:503-413-2200
Practice Address - Fax:503-413-1119
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORDO16923207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR061606Medicaid
ORE68732Medicare UPIN