DR. BEVERLY ANN DE LA BRUERE NPI 1720176332

NPI Information

  • NPI: 1720176332
  • Provider Name: DR. BEVERLY ANN DE LA BRUERE
  • Classification: Family Medicine - 207QA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Individual
  • CLIA Number: 38D0621790
  • Address: 18151 SE HIGHWAY 212
    DAMASCUS, OR
    ZIP 97089
  • Phone: (503) 658-6022

Map and Directions

Get Directions

NPI Details

DR. Beverly Ann De La Bruere is an addiction medicine family medicine in Damascus, OR. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. DR. Beverly Ann De La Bruere NPI is 1720176332. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

18151 SE HIGHWAY 212
DAMASCUS, OR
ZIP 97089-764
Phone: (503) 658-6022
Fax: (503) 658-7818

The CLIA number assigned to this NPI record is 38D0621790 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/10/2006 and was last updated on 8/2/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QA0401XFamily MedicineAddiction MedicineMD15031OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C92493MEDICARE UPINOREGON
2R0000BHXVZMEDICARE ID-TYPE UNSPECIFIEDOREGON
3110403MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI