Individual
MS. JANICE M BERGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
15100 BOONES FERRY RD, SUITE 700A, LAKE OSWEGO, OR 97035-3469
(503) 636-2877
(503) 635-9127
Mailing address
15100 BOONES FERRY RD, SUITE 700A, LAKE OSWEGO, OR 97035-3469
(503) 636-2877
(503) 635-9127
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW1156
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1156
LCSW
OR
Enumeration date
06/25/2008
Last updated
06/25/2008
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