Kaija Bergdale
Individual provider Active NPI Speech-Language Pathologist · Marysville, WA
NPI 1336780741 · NPPES record last updated Apr 15, 2021
Key facts
- NPI
- 1336780741
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 61094008 (WA)
- Practice address
- 4317 76TH St NE
Marysville, WA 98270-3768 - Phone
- (360) 965-0225
- NPI assigned
- Oct 7, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61094008 | WA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 61094008 | WA | Yes |
Addresses
Primary practice location
4317 76TH St NE
Marysville, WA 98270-3768
Mailing address
22234 C80
Sioux City, IA 51108-8627
Other providers in Marysville, WA
- Dominic Bellows
- Julie Bennett
- Patricia Ann Benz
- Regina Ann Benzel
- Angelique Marie Berens
- Cierra J Berger
- Sarah Eva Bergman Lewis
- Jack M. Bergstein
- Stacy A Berkenpas
- Konstantin Berov
All providers in Marysville, WA · Speech-Language Pathologist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.