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NPI Code Detail

MEDICARE: SOPHIA CATHERINE BERGUM

MEDICARE: SOPHIA CATHERINE BERGUM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist551891OR

General Provider Information

NPI Number : 1912833195
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIA CATHERINE BERGUM
Provider Business Mailing Address
First Line : 828 W 13TH ST
Second Line :
City : MEDFORD
State : OR
Zip : 97501-3428
Country : US
Telephone Number : 406-459-8277
Fax Number :
Provider Business Practice Location Address
First Line : 1200 MIRA MAR AVE
Second Line :
City : MEDFORD
State : OR
Zip : 97504-8546
Country : US
Telephone Number : 406-459-8277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2026
Last Update Date : 06/23/2026

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Directions to “ SOPHIA CATHERINE BERGUM ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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