Provider Demographics
NPI:1144755646
Name:BERMAN, AMY BETH
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:BETH
Last Name:BERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 SW 3RD AVE STE 3703
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-2405
Mailing Address - Country:US
Mailing Address - Phone:503-482-2800
Mailing Address - Fax:503-482-2844
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:971-304-2421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-22
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist