Bryan James Bergstrom, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF61629246 Issued in WA

Practice address

16114 E Indiana Ave Ste 210
Spokane Valley, WA 99216-1874

Phone

(509) 761-6587

Fax

(360) 326-7224

NPI assigned

Oct 5, 2024

Sex

Male

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

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Refresh Therapy, Inc

  • Marriage & Family Therapist
  • Vancouver, WA
  • NPI 1225403454
  Medicare reassignment NPD
• Refresh Therapy, Inc

  • Mental Health Counselor
  • Vancouver, WA
  • NPI 1235064858
  NPD (past)

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

{
    "created_epoch": "1728086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1588483739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16114 E INDIANA AVE STE 210",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161874",
            "telephone_number": "509-761-6587",
            "fax_number": "360-326-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16114 E INDIANA AVE STE 210",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161874",
            "telephone_number": "509-761-6587",
            "fax_number": "360-326-7224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13505 NE 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986852711",
            "country_code": "US",
            "telephone_number": "360-433-9664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "BRYAN",
        "middle_name": "JAMES",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-05",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61629246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy A Berg, M.D.
• Bailey Bergdahl
• Nicholas Alvin Bergen
• Morgan Berggren-Mustard
• Jessica Beth Berghoff, RD CD
• Tristina Krakenberg Bermingham
• JB McGregor Bermudez-Koch, DMD DE61197009
• Erin Berry
• Kirsten Sunshine Berry
• Shona M Bertholf

• Marriage & Family Therapist in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.