Individual
MR. HAROLD GEORGE VON BERGEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
210 FERRY ST, SEDRO WOOLLEY, WA 98284-1411
(360) 856-4216
(360) 856-4217
Mailing address
16431 PUTTER CIR, BURLINGTON, WA 98233-3802
(360) 757-0746
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT00000529
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31210
STATE INDUSTRIAL
WA
05
—
70040-05
—
WA
Enumeration date
08/10/2005
Last updated
07/08/2007
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