Individual
ALEXANDER L BERTELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 543-3690
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004919
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8443269
—
WA
01
—
P00466583
RAILROAD MEDICARE
WA
Enumeration date
04/09/2007
Last updated
05/30/2008
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