Individual
MARJORIE A BERGSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1608 S J ST FL 2, TACOMA, WA 98405-4930
(253) 274-7503
(269) 654-1192
Mailing address
1608 S J ST, FLOOR 2, 0, TACOMA, WA 98405-4930
(253) 274-7503
(269) 654-1192
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003841
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0205196
STATE L&I
WA
01
—
0289063
STATE L&I
WA
01
—
0290553
STATE L&I
WA
05
—
1042943
—
WA
05
—
8357279
—
WA
01
—
8940935
STATE CRIME VICTIMS
WA
Enumeration date
08/01/2006
Last updated
12/01/2020
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