| Dr Theodore J Bergstrom, MD | |
|
55 W Tietan St, Walla Walla, WA 99362-4445 | |
| (509) 525-3720 | |
| (509) 522-1578 |
| Full Name | Dr Theodore J Bergstrom |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 55 W Tietan St, Walla Walla, Washington |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598739716 | NPI | - | NPPES |
| 1007525 | Medicaid | WA | |
| 10041910 | Other | WA | RAIL ROAD MEDICARE |
| 152421 | Medicaid | OR | |
| 40225 | Other | WA | L&I |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | MD00022923 (Washington) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Theodore J Bergstrom, MD 55 W Tietan St, Walla Walla, WA 99362-4445 Ph: (509) 525-3720 | Dr Theodore J Bergstrom, MD 55 W Tietan St, Walla Walla, WA 99362-4445 Ph: (509) 525-3720 |
Timothy Isamu O'connor, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 55 W Tietan St, Walla Walla, WA 99362 Phone: 509-525-3720 | |
Rebekah Dickman, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 55 W Tietan St, Walla Walla, WA 99362 Phone: 509-525-3720 Fax: 509-522-1593 | |
Donald K Ashley, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1111 S 2nd Ave, Walla Walla, WA 99362 Phone: 509-522-0100 Fax: 509-527-8010 | |
Jaslyn Esther Erickson, MD Pediatrics Medicare: May Accept Medicare Assignments Practice Location: 55 W Tietan St Bldg A, Walla Walla, WA 99362 Phone: 509-525-3720 | |
Dr. Alison E Kirby, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 55 W Tietan St, Walla Walla, WA 99362 Phone: 509-525-3720 Fax: 509-522-1578 | |
Kristin Marie Satterfield, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1111 S 2nd Ave, Walla Walla, WA 99362 Phone: 509-527-8152 | |
Trent D. Rogers, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 55 West Tietan Street, Walla Walla, WA 99362 Phone: 509-525-3720 Fax: 509-522-1593 |