Individual
MRS. MARISA ELAINE BERGLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
51 W DAYTON ST, SUITE 304, EDMONDS, WA 98020-4111
(425) 582-0884
(425) 778-2604
Mailing address
304 N 149TH ST, SHORELINE, WA 98133-6411
(206) 850-3858
(425) 778-2604
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00016829
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0161538
LABOR AND INDUSTRIES
WA
Enumeration date
11/30/2006
Last updated
06/08/2015
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