Bergeron, Breanna K

Bergeron, Breanna K is an individual health care provider with primary practice located at 212 E Central Ave Ste. 440, Spokane WA 99208-6291. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Bergeron, Breanna K can be contacted via phone (509) 252-9602.

Contact Information

Primary practice address
212 E Central Ave Ste. 440 Spokane WA 99208-6291
Phone: (509) 252-9602
Fax: (509) 227-7070
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 175 Alaska
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X D-530 Idaho
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X DI60595970 Washington

Profile Details

NPI number 1013040849
LBN Legal business name Bergeron, Breanna K
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 13th, 2007
Last updated Mar 24th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013040849 NPPES
Alaska MEDICAID DT9813

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