Individual
CARRIE BERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1445 NW MALL ST STE 2, ISSAQUAH, WA 98027-7900
(510) 325-7883
Mailing address
1445 NW MALL ST STE 2, ISSAQUAH, WA 98027-7900
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/26/2021
Last updated
07/26/2021
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