Individual
BETSY S BERGQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA LMHC
Contact information
Practice address
1800 COOPER POINT RD SW, BLDG 17, OLYMPIA, WA 98502-1178
(908) 329-5877
Mailing address
1800 COOPER POINT RD SW, BLDG 17, OLYMPIA, WA 98502-1178
(908) 329-5877
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00005791
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00005791
WASHINGTON STATE DEPARTMENT OF HEALTH LMHC LICENSE#
WA
Enumeration date
09/21/2011
Last updated
09/21/2011
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