Bergstrom, Robert W

Bergstrom, Robert W is an individual health care provider with primary practice located at 831 Nw Council Dr Suite 125, Gresham OR 97030-3721. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Bergstrom, Robert W can be contacted via phone (503) 661-3439.

Contact Information

Primary practice address
831 Nw Council Dr Suite 125 Gresham OR 97030-3721
Fax: (503) 669-1360
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD24029 Oregon

Profile Details

NPI number 1982660700
LBN Legal business name Bergstrom, Robert W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2006
Last updated Mar 17th, 2010 - about 14 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 1982660700 NPPES
Washington MEDICAID 8372849
Washington MEDICAID 286638

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