Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Ethan A Berry, MSNCRNA

Individual provider Registered Nurse · NPI 1710094941

Mr. Ethan A Berry, MSNCRNA is a Certified Registered Nurse Anesthetist (CRNA) in Clackamas, Oregon. Qualified in 2005, 21 years ago. Practices with Kaiser Foundation Health Plan of the Northwest, a 1,811-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
21
Licensed in
OR
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone: (909) 967-1734
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 200560041CRNA (OR)
Registered Nurse Taxonomy 163W00000X · Licence 200560041CRNA (OR)

Record details

NPI number1710094941
Entity typeIndividual (Type 1)
GenderMale
Credentials MSNCRNA
Sole proprietorNo
NPI enumeratedAugust 24, 2006
Last updated in NPPESNovember 20, 2009

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Kaiser Foundation Health Plan Of The Northwest — 1811 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Clackamas