# DR PAUL A BERGHUIS INC PS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053509968
- **Authorized official:** CHAR MELDAHL (BILLING AGENT)
- **Authorized official phone:** (360) 466-2542

## Contact information

- **Practice address:** 1401 S LAVENTURE RD, MOUNT VERNON, WA 98274-6033
- **Practice address phone:** (360) 336-6517
- **Mailing address:** PO BOX 104, MOUNT VERNON, WA 98273-0104
- **Mailing address phone:** (360) 336-6517

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | OP00001383 | WA | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | OP00001383 | WA | — |

## Other

- **Enumeration date:** 10/05/2007
- **Last updated:** 05/22/2008