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Contact Information

DEZIRAE E BERRY, NP-C
1119 HIGHLAND AVE
CLARKSTON, WA99403-2836
 Phone: 509-769-2269
 Fax: 509-769-2270
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for DEZIRAE E BERRY · (Female)

NPI Number 1740994268
Status Active
Credentials NP-C (Nurse Practitioner - Certified)
Entity Individual
Enumeration date 01/09/2023
Last updated 10/08/2025 - About 8 months ago
Sole proprietor 1 No
Identifiers
  • ID License # 55464
  • WA License # N361446320
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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