Provider Demographics
NPI:1265580443
Name:BERGET, ANNETTE E (LMP)
Entity type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:E
Last Name:BERGET
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10016 MYERS WAY S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98168-1356
Mailing Address - Country:US
Mailing Address - Phone:206-910-4825
Mailing Address - Fax:206-260-8822
Practice Address - Street 1:10016 MYERS WAY S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98168-1356
Practice Address - Country:US
Practice Address - Phone:206-910-4825
Practice Address - Fax:206-260-8822
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00010139225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist