Bergstrom, John O
Bergstrom, John O is an individual health care provider with primary practice located at 9155 Sw Barnes Rd, Suite 634, Portland OR 97225-6633. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Bergstrom, John O can be contacted via phone (503) 297-4123.Contact Information
Primary practice address
9155 Sw Barnes Rd, Suite 634
Portland OR 97225-6633
Phone: (503) 297-4123
Fax: (503) 297-0344
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | MD06700 | Oregon |
Profile Details
| NPI number | 1639122013 |
|---|---|
| LBN Legal business name | Bergstrom, John O |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1639122013 | NPPES |
| Oregon | Other | MD06700 | LICENSE |
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