Provider Demographics
NPI:1275582819
Name:BERNSTEIN, ALBERT JOSEPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:JOSEPH
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 22ND ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-3266
Mailing Address - Country:US
Mailing Address - Phone:360-693-8439
Mailing Address - Fax:360-696-4811
Practice Address - Street 1:200 E 22ND ST
Practice Address - Street 2:SUITE C
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-3266
Practice Address - Country:US
Practice Address - Phone:360-693-8439
Practice Address - Fax:360-696-4811
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA556103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA36805Medicare ID - Type Unspecified