Active NPI
Audrey Lee Bergsma, N.D.
- Naturopath
- Portland, OR
National Provider Identifier
1114066271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- 871
- Practice address
- 2220 SW 1St Ave
Portland, OR 97201-5003 - Phone
- (503) 552-1590
- Fax
- (503) 226-8133
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 871 | OR | Primary |
Addresses
Primary practice location
2220 SW 1St Ave
Portland, OR 97201-5003
Mailing address
2220 SW 1St Ave
Portland, OR 97201-5003
Phone (503) 552-1590
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 871 | OR | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114066271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2220 SW 1ST AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972015003",
"telephone_number": "503-552-1590",
"fax_number": "503-226-8133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2220 SW 1ST AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972015003",
"telephone_number": "503-552-1590",
"fax_number": "503-226-8133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGSMA",
"first_name": "AUDREY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "N.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "OR",
"license": "871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.