Individual
KENNETH S BERGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11511 CANTERWOOD BLVD NW, SUITE 50, GIG HARBOR, WA 98332-5813
(253) 851-5155
(253) 851-5367
Mailing address
314 MLK JR WAY, STE 11, TACOMA, WA 98405
(253) 627-6172
(253) 627-8792
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD00030100
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8293987
—
WA
Enumeration date
02/01/2006
Last updated
08/28/2012
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