NPI 1902124910 · live from the CMS NPI Registry
Bjorn Paul Bergstrom, Psy.D.
Psychologist, Clinical in Portland, OR. National Provider Identifier 1902124910, active.
NPI record
| NPI | 1902124910 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 1130 Sw Morrison St, Suite 619, Portland, OR 97205 |
| Practice phone | 503-780-3723 |
| Mailing address | 1130 Sw Morrison St Ste 619, Portland, OR 97205 |
| Enumerated | May 14, 2010 |
| Last updated | February 24, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Mental Health | 101YM0800X | — |
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Psychologist, Clinical primary | 103TC0700X | 2444 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.