Individual
MS. JENNIFER EDNA BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
9800 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9750
(503) 652-2880
Mailing address
832 NW 67TH ST, SEATTLE, WA 98117-5133
(206) 351-3541
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1060074
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1060074
OTR
OR
Enumeration date
11/15/2006
Last updated
07/08/2007
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