Individual
MRS. CASEY AMANDA BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
1550 4TH AVE S, SEATTLE, WA 98134-1510
(206) 516-7778
(253) 752-0514
Mailing address
2466 CALLAWAY LN SW, TUMWATER, WA 98512-8019
(360) 878-3905
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00006132
WA
Other
Enumeration date
10/29/2012
Last updated
01/27/2016
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