Doctor Name: | DR. JACLYN MERRY BERGSTROM |
NPI Number: | 1598715336 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.C |
License Number: | 705 |
Business Practice Address: | 8810 Se Sunnybrook Blvd Ste. 100 Clackamas, OR - 970156804 |
Business Phone Number: | 5036072226 |
Business Fax Number: | 5036592276 |
Mailing Address: | 8810 Se Sunnybrook Blvd, Ste. 100 CLACKAMAS |
State: | OR |
Postal Code: | 970156804 |
Phone Number: | 5036072226 |
Fax Number: | 5036592276 |
NPI Enumeration Date: | 05/11/2006 |
NPI Last Update Date: | 05/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 705 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ND |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |