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General NPI Number Information
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NPI Number | 1194218305
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Entity Type | Individual
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Provider Name | MARY PAT BERGIN RN
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Gender | Female
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 32901 WEYERHAEUSER WAY S
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City | FEDERAL WAY
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State | WA
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Zip | 98001-9348
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Country | US
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Telephone | 253-924-2833
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Fax |
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Provider Business Mailing Address
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Address Line | 6021 39TH AVE SW
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City | SEATTLE
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State | WA
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Zip | 98136-1601
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Country | US
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Telephone | 253-952-0304
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WX0106X
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Taxonomy Name | Occupational Health Registered Nurse
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License Number | RN00102745
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License Number State | WA
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