Demographics
DOB: Oct 9, 1961
Sex: M
Status: active
Email: dbquadrider1@gmail.com
Mobile: 5035807850
Home: 5035807850
Department: WEST SALEM
Primary Provider: Emma Stacey
Last Synced: May 26, 2026, 10:59 AM
Address: 1112 Orchard Ct N, KEIZER, OR, 97303
Allergy (1)
| Type | Description | Onset / Date | Status |
|---|---|---|---|
| Allergy | Aug 6, 2021 | — |
Problem (12)
| Type | Description | Onset / Date | Status |
|---|---|---|---|
| Problem | Jan 26, 2026 | — | |
| Problem | Feb 19, 2026 | — | |
| Problem | Aug 28, 2025 | — | |
| Problem | Feb 19, 2026 | — | |
| Problem | Sep 16, 2025 | — | |
| Problem | Aug 28, 2025 | — | |
| Problem | Feb 19, 2026 | — | |
| Problem | Aug 28, 2025 | — | |
| Problem | Jan 26, 2026 | — | |
| Problem | Sep 16, 2025 | — | |
| Problem | Sep 16, 2025 | — | |
| Problem | Sep 16, 2025 | — |
Vital (7)
| Type | Description | Onset / Date | Status |
|---|---|---|---|
| Vital | Feb 19, 2026 | — | |
| Vital | Feb 19, 2026 | — | |
| Vital | Feb 19, 2026 | — | |
| Vital | Feb 19, 2026 | — | |
| Vital | Feb 19, 2026 | — | |
| Vital | Feb 19, 2026 | — | |
| Vital | Feb 19, 2026 | — |
Well-Life Assistant
File: BERGEVIN, Dennis A.
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