Provider Demographics
NPI:1750636692
Name:BERGMANN, CINDY MINH (RPH)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:MINH
Last Name:BERGMANN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15715 36TH DR SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-4747
Mailing Address - Country:US
Mailing Address - Phone:206-850-6215
Mailing Address - Fax:
Practice Address - Street 1:15715 36TH DR SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-4747
Practice Address - Country:US
Practice Address - Phone:206-850-6215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH0005426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist