Individual
KYLE BERGMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3517 NW SAMARITAN DR STE 200, CORVALLIS, OR 97330-3767
(541) 768-6429
(541) 768-6514
Mailing address
3517 NW SAMARITAN DR STE 200, CORVALLIS, OR 97330-3767
(541) 768-6429
(541) 768-6514
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000899
OR
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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