Individual
KAIJA BERGDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4317 76TH ST NE, MARYSVILLE, WA 98270-3768
(360) 965-0225
Mailing address
22234 C80, SIOUX CITY, IA 51108-8627
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
61094008
WA
Other
Enumeration date
10/07/2019
Last updated
04/15/2021
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