Organization
BERGSTROM FAMILY EYECARE P S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER BALDWIN OD (PRESIDENT)
(509) 493-2020
Entity
Organization
Contact information
Practice address
950 E JEWETT BLVD., WHITE SALMON, WA 98672
(509) 493-2020
(509) 493-2023
Mailing address
PO BOX 1789, WHITE SALMON, WA 98672-1789
(509) 493-2020
(509) 493-2023
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
600024606
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2215309
—
WA
Enumeration date
11/13/2006
Last updated
06/09/2022
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