Individual
MRS. KATHLEEN A BERGQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
400 S 43RD ST, RENTON, WA 98055-5714
(425) 353-3588
(425) 353-8041
Mailing address
7244 E MERCER WAY, MERCER ISLAND, WA 98040-5817
(206) 232-4806
(425) 353-8041
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00042447
WA
363L00000X
Nurse Practitioner
AP30004852
WA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30004852
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046242
LABOR AND INSDUSTRIES
WA
05
—
9610106
—
WA
Enumeration date
08/31/2006
Last updated
07/15/2013
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