Individual
ROBERT W BERGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
831 NW COUNCIL DR, SUITE 125, GRESHAM, OR 97030-3721
(503) 661-3439
(503) 669-1360
Mailing address
PO BOX 92900, PORTLAND, OR 97292-0900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD24029
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286638
—
OR
05
—
8372849
—
WA
Enumeration date
04/21/2006
Last updated
03/17/2010
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