Bergstrom, Jaclyn Merry
Bergstrom, Jaclyn Merry is an individual health care provider with primary practice located at 2900 Ne 132Nd Ave , Portland OR 97230-3014. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Bergstrom, Jaclyn Merry can be contacted via phone (503) 255-6771.Contact Information
Primary practice address
2900 Ne 132Nd Ave
Portland OR 97230-3014
Phone: (503) 255-6771
Fax: (503) 251-5794
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 705 | North Dakota |
| Chiropractic Providers / Chiropractor | 111N00000X | 4665 | Minnesota |
| Chiropractic Providers / Chiropractor | 111N00000X | 5133 | Oregon |
Profile Details
| NPI number | 1598715336 |
|---|---|
| LBN Legal business name | Bergstrom, Jaclyn Merry |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 11th, 2006 |
| Last updated | Nov 8th, 2018 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598715336 | NPPES |
| Minnesota | MEDICAID | 044057400 |
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