Individual
MRS. JACQUELINE ELISE BERNHAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
456 C ST, BLAINE, WA 98230-4238
(360) 332-8733
Mailing address
1213 WHATCOM ST APT 119, BELLINGHAM, WA 98229-5763
(918) 720-4407
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201847167WA
—
WA
Enumeration date
08/27/2021
Last updated
08/27/2021
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