Individual
DR. JACLYN MERRY BERGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C
Contact information
Practice address
2900 NE 132ND AVE, PORTLAND, OR 97230-3014
(503) 255-6771
(503) 251-5794
Mailing address
2900 NE 132ND AVE, PORTLAND, OR 97230-3014
(503) 255-6771
(503) 251-5794
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
4665
MN
111N00000X
Chiropractor
Primary
5133
OR
111N00000X
Chiropractor
705
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044057400
—
MN
Enumeration date
05/11/2006
Last updated
11/08/2018
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