Individual
MS. TONI R BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CADC III, CDP
Contact information
Practice address
1300 JOHN ADAMS ST, SUITE 103, OREGON CITY, OR 97045-1695
(503) 841-8458
(503) 650-1970
Mailing address
340 W CLARENDON ST, GLADSTONE, OR 97027-2339
(503) 841-8459
(503) 657-2800
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
07-06-65
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP00005704
WA
101YP2500X
Professional Counselor
Primary
C2297
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194884460
NATIONAL PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/06/2006
Last updated
12/07/2016
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