Individual
MATTHEW BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
17500 SE 392ND ST, AUBURN, WA 98092-9705
(253) 333-3619
(253) 333-6853
Mailing address
17500 SE 392ND ST, AUBURN, WA 98092-9705
(253) 333-3619
(253) 333-6853
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60303556
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH60303556
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
03/16/2016
Last updated
03/16/2016
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