Individual
JOHANN V BERNARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1708 YAKIMA AVE, STE 110, TACOMA, WA 98405-5307
(253) 627-9151
(253) 591-8892
Mailing address
1708 YAKIMA AVE, STE 110, TACOMA, WA 98405-5307
(253) 627-9151
(253) 591-8892
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00037004
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0141790
STATE L&I
WA
01
—
110215237
RAILROAD
WA
05
—
8250417
—
WA
01
—
8930007
STATE CRIME VICTIMS
WA
Enumeration date
08/05/2006
Last updated
11/16/2010
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