Kaija Bergdale

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

61094008 Issued in WA

Practice address

4317 76TH St NE
Marysville, WA 98270-3768

Phone

(360) 965-0225

NPI assigned

Oct 7, 2019

Last updated

Apr 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1336780741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22234 C80",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511088627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4317 76TH ST NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982703768",
            "telephone_number": "360-965-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGDALE",
        "first_name": "KAIJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "61094008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominic Bellows, LMP
• Julie Bennett
• Patricia Ann Benz
• Regina Ann Benzel, RC 60084796
• Angelique Marie Berens, M.D.
• Cierra J Berger, LMP
• Sarah Eva Bergman Lewis, M.D.
• Jack M. Bergstein, M.D.
• Stacy A Berkenpas, BA
• Konstantin Berov

• Speech-Language Pathologist in Marysville, WA
• Providers in Marysville, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.