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Individual

SARA E BERGMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAC

Contact information

Practice address
723 NW 18TH AVENUE, PORTLAND, OR 97209-2315
(503) 791-4648
Mailing address
723 NW 18TH AVENUE, PORTLAND, OR 97209-2315
(503) 791-4648

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC173854
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500706395
OR
Enumeration date
01/02/2016
Last updated
12/15/2022
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