Individual
ELIZABETH ANNE BERGENDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHA IP
Contact information
Practice address
16047A HIGHWAY 12, CLARKSTON, WA 99403-9753
(360) 451-0267
Mailing address
16047A HIGHWAY 12, CLARKSTON, WA 99403-9753
(360) 451-0267
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/04/2023
Last updated
09/04/2023
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