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Individual

SHAWN EVERETT BERGAMASCHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CHA-T

Contact information

Practice address
1000 GREG KRUSHEK AVE, NOME, AK 99762-9976
(907) 638-3311
(907) 638-2007
Mailing address
1 SCOW JOHN ROAD, WHITE MOUNTAIN, AK 99784
(907) 638-3311
(907) 638-2007

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CHA-T
CHA-T
AK
Enumeration date
09/02/2021
Last updated
09/02/2021
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