| Organization Name: | BERGSTROM FAMILY EYECARE P S |
| NPI Number: | 1184795684 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBORAH K BERGSTROM (OWNER OPTOMETRIC PHYSICIAN) |
| Mailing Address: | 950 E Jewett Blvd. White Salmon |
| State: | WA US |
| Postal Code: | 98672 |
| Phone Number: | 5094932020 |
| Fax Number: | 5094932023 |
| NPI Enumeration Date: | 11/13/2006 |
| NPI Last Update Date: | 02/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | 600024606 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |