Jonathan Michael Berger, M.D.
Individual provider Active NPI Family Medicine Physician · Tualatin, OR
NPI 1326017997 · NPPES record last updated Feb 18, 2011
Key facts
- NPI
- 1326017997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD11070 (OR)
- Practice address
- 19875 SW 65TH Ave
Tualatin, OR 97062-8353 - Phone
- (503) 692-7785
- Fax
- (503) 885-1663
- NPI assigned
- Mar 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Meridian Park Pediatric Rehab | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD11070 | OR | Yes |
Addresses
Primary practice location
19875 SW 65TH Ave
Tualatin, OR 97062-8353
Mailing address
19875 SW 65TH Ave
Tualatin, OR 97062-8353
Phone (503) 692-7785
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 018317 | Medicaid | OR |
Other providers in Tualatin, OR
- Benchmark Clinic of Integrative Medicine, PC
- Yanina M Benikova
- Danielle Benjamin
- Cynthia Elizabeth Bennett
- Adam Berens
- Berk Neurosurgical, LLC
- Angela Bertsch
- Better Hearing Solutions
- Anthony Betz
- Michael Bigelow
All providers in Tualatin, OR · Family Medicine Physician in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.