Marisa Elaine Berglund, L.M.P.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA00016829 Issued in WA

Practice address

51 W Dayton St
Suite 304
Edmonds, WA 98020-4111

Phone

(425) 582-0884

Fax

(425) 778-2604

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1285702233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 N 149TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981336411",
            "telephone_number": "206-850-3858",
            "fax_number": "425-778-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 W DAYTON ST",
            "address_2": "SUITE 304",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980204111",
            "telephone_number": "425-582-0884",
            "fax_number": "425-778-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGLUND",
        "first_name": "MARISA",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00016829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0161538",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Raymond Benoit, BA RC
• Sarah Bentz
• Sondra Beres, PHD
• Azzura Bergendahl
• Karen Leigh Berglund, DDS
• Ghrmawit T Berhane, CNA
• Laine Berkeley, R.N., B.S.N.
• Crystal L Bernstein, M.D.
• Gabriel Berson, MD
• Wendy Anne Bertram, LMHC

• Specialist in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.