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Individual

DR. ANTHONY W BERGSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O. D.

Contact information

Practice address
136 NW 2ND ST, STEVENSON, WA 98648-4225
(509) 427-2020
(509) 427-8268
Mailing address
PO BOX 378, STEVENSON, WA 98648-0378
(509) 427-2020
(509) 427-8268

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00003314
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2022325
WA
Enumeration date
11/13/2006
Last updated
08/02/2013
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