Individual
ALWIN JED BERGONIA SACRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11511 NE 10TH ST, BELLEVUE, WA 98004-8578
(425) 502-3000
Mailing address
18502 96TH AVE E, PUYALLUP, WA 98375-6330
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT61372228
WA
Other
Enumeration date
03/13/2023
Last updated
06/13/2023
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