Bergstrom Family Eyecare P S

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

600024606 Issued in WA

Legal business name

BERGSTROM FAMILY EYECARE P S

Practice address

950 E Jewett Blvd.
White Salmon, WA 98672

Phone

(509) 493-2020

Fax

(509) 493-2023

NPI assigned

Nov 13, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Alexander Baldwin, OD

Title

President

Phone

(509) 493-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anthony W Bergstrom, O. D.

  • Optometrist
  • Stevenson, WA
  • NPI 1306917356
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1184795684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1789",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986721789",
            "telephone_number": "509-493-2020",
            "fax_number": "509-493-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E JEWETT BLVD.",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "98672",
            "telephone_number": "509-493-2020",
            "fax_number": "509-493-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGSTROM FAMILY EYECARE P S",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-493-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "WA",
            "license": "600024606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2215309",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex Baldwin, O.D.
• Carla Barajas, RN
• Christopher Barker
• Douglas Arthur Barnard I, D.C
• Phoebe Elise Belsky, MS
• Jillian Doran Bingham, BSN, RN
• Ticia Ann Blanck, PSY.D.
• Margot R Bolstad, DO
• Shelby Taylor Bowerly, DNP, APRN, FNP-C
• Jillian Brown, LPC ASSOCIATE

• Eyewear Supplier in White Salmon, WA
• Providers in White Salmon, WA by specialty
• Eyewear Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.