Individual
SARA A BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1623 5TH ST, SUITE B, CLARKSTON, WA 99403
(509) 758-0128
(509) 758-0402
Mailing address
1623 5TH ST, SUITE B, CLARKSTON, WA 99403
(509) 758-0128
(509) 758-0402
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
M5872
ID
207V00000X
Obstetrics & Gynecology Physician
Primary
MD00029192
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010004632
REGENCE BLUE SHIELD
ID
01
—
0005356454
AETNA
—
05
—
002685500
—
ID
05
—
1067362
—
WA
01
—
152174XX
PREFERRED CARE
—
01
—
2005013110402042
PREMERA BLUE CROSS
WA
01
—
3083164231BERSA
MEDICAL SERVICES CORP
WA
01
—
58727
BLUE CROSS OF IDAHO
ID
Enumeration date
09/09/2005
Last updated
06/29/2010
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