DR. BEVERLY ANN DE LA BRUERE (NPI# 1720176332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720176332 |
| Entity Type | Individual |
| Full Name | DR. BEVERLY ANN DE LA BRUERE |
| Practice Address |
18151 Se Highway 212 Damascus OR 97089-8764 |
| Practice Telephone | 5036586022 |
| Practice Fax Number | 5036587818 |
| Mailing Telephone | 5036586022 |
| Mailing Fax Number | 5036587818 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-08-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
MD15031 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 110403 | 05 |
| Street Address |
18151 SE HIGHWAY 212 |
| City | DAMASCUS |
| State | OR |
| Zip Code | 97089-8764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407205313 | Healthy Choices Wellness Center Inc | Clinic/Center | 18151 Se Highway 212, Damascus, OR 97089-8764 | 2016-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841381423 | Therese M Scott | Family Medicine | 11131 Se 190th Ct, Damascus, OR 97089 | 2006-09-27 |
| 1699888552 | James Robert Bowles | Nurse Anesthetist, Certified Registered | 22225 Se Peggy Ann Dr., Damascus, OR 97089 | 2006-08-16 |
| 1164747762 | Thomas Dutcher D.c., P.C. Inc. | Chiropractor | 14605 Se 202nd Ave, Damascus, OR 97089 | 2010-04-07 |
| 1306285028 | Kelli Jo Scott | Dental Hygienist | 15691 Se Royer Rd, Damascus, OR 97089-2642 | 2013-06-15 |
| 1700385572 | Ashley Heacock | Specialist/Technologist | 15690 Se Heidi Ln, Damascus, OR 97089-2752 | 2018-02-07 |
| 1457973992 | Tammy T Nguyen | Optometrist | 16801 Se Davidoff Way, Damascus, OR 97089-5801 | 2020-05-07 |
| 1588755490 | Justin Thomas Weatherford | Physical Therapist | 9148 Se Hideaway Ct, Damascus, OR 97089-6324 | 2006-09-27 |
| 1023428034 | Victoria L. Larson | General Practice | 10,000 Se 222nd Ave., Damascus, OR 97089-6517 | 2014-04-29 |
| 1558979906 | Janet Lee Gassman | Counselor | 13550 Se 215th Ct, Damascus, OR 97089-7220 | 2020-07-21 |
| 1508150806 | Erin Page Giusto | Mechanotherapist | 24375 Se Strawberry Dr, Damascus, OR 97089-7364 | 2011-06-03 |
| Find all providers in zip 97089 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649838590 | Boulder Care Provider Group Pa | Family Medicine | 208 Sw Harvey Milk St Ste 200, Portland, OR 97204-2611 | 2019-06-04 |
| 1558882969 | Ideal Option, Pllc | Family Medicine | 545 Se Oak St Ste D, Hillsboro, OR 97123-4147 | 2017-07-06 |
| 1912376534 | Fusion Health Services | Family Medicine | 2284 Rogue Way, West Linn, OR 97068-8322 | 2015-09-24 |
| 1417333535 | Ascension Health Centers | Family Medicine | 8083 Se 13th Ave, Suite #3, Portland, OR 97202-6668 | 2015-07-31 |
| 1316006166 | Stephen Cameron | Family Medicine | 3449 N Anchor St, Suite 300a, Portland, OR 97217-7679 | 2006-12-07 |
| 1861508632 | M. Jamie Mcallister, D. O., P. C. | Family Medicine | 711 Ne Irving Ave., Bend, OR 97701-4738 | 2006-08-22 |
| 1316929821 | Mary James Mcallister | Family Medicine | 711 Ne Irving Ave, Bend, OR 97701-4738 | 2005-11-18 |
| 1922582493 | Oasis Center of The Rogue Valley | Family Medicine | 1025 E Main St Ste 108, Medford, OR 97504-7448 | 2018-09-20 |
| 1467995324 | Clear Path | Family Medicine | 2364 Main St, Suite A, Philomath, OR 97370-9488 | 2016-11-28 |
| 1215386776 | Clear Path Center, P.a. | Family Medicine | 2364 Main St, Suite A, Philomath, OR 97370-9488 | 2016-06-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.