Provider Demographics
NPI:1881233328
Name:BERGERON, HANNAH MAE (MSW)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:MAE
Last Name:BERGERON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15617 SE 173RD ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-9121
Mailing Address - Country:US
Mailing Address - Phone:360-213-4720
Mailing Address - Fax:
Practice Address - Street 1:15617 SE 173RD ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-9121
Practice Address - Country:US
Practice Address - Phone:360-213-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-01
Last Update Date:2020-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health