Individual
GWEN BERNACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-4300
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD6094847
WA
207RC0000X
Cardiovascular Disease Physician
Primary
MD6094847
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134319791
—
WA
Enumeration date
07/30/2007
Last updated
02/02/2016
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