BREANNA K BERGERON (NPI# 1013040849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013040849 |
| Entity Type | Individual |
| Full Name | BREANNA K BERGERON |
| Credential | RD |
| Practice Address |
212 E Central Ave Ste. 440 Spokane WA 99208-6291 |
| Mailing Address |
Po Box 421 Liberty Lake WA 99019-0421 |
| Practice Telephone | 5092529602 |
| Practice Fax Number | 5092277070 |
| Mailing Telephone | 8667472455 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2017-03-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | DI60595970 | WA | Dietary & Nutritional Service Providers |
| N | 133V00000X | Dietitian, Registered | D-530 | ID | Dietary & Nutritional Service Providers |
| N | 133V00000X | Dietitian, Registered | 175 | AK | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | DT9813 | 05 |
| Street Address |
212 E CENTRAL AVE STE. 440 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99208-6291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477550572 | Philip Coff | Internal Medicine | 212 E Central Ave, Suite 440, Spokane, WA 99208-6291 | 2005-07-05 |
| 1881059954 | Providence Health & Services Washington | Prosthetic/Orthotic Supplier | 212 E Central Ave, Suite 245, Spokane, WA 99208-6291 | 2015-12-16 |
| 1881096774 | Timothy Brim | Physician Assistant | 212 E Central Ave, Suite 365, Spokane, WA 99208-6291 | 2014-09-23 |
| 1295135598 | Providence Physician Services Co. | Orthopaedic Surgery | 212 E Central Ave, Suite 245, Spokane, WA 99208-6291 | 2014-08-25 |
| 1841605433 | Nicole Breen | Family Medicine | 212 E Central Ave, Spokane, WA 99208-6291 | 2014-06-23 |
| 1154614469 | Jessica Renae Craddock | Internal Medicine | 212 E Central Ave, Suite 440, Spokane, WA 99208-6291 | 2011-05-19 |
| 1639471667 | Daniel J Simon | Physician Assistant | 212 E Central Ave, Suite 440, Spokane, WA 99208-6291 | 2010-11-24 |
| 1609182070 | David Bryan Ramey | Psychiatry & Neurology | 212 E Central Ave, Suite 315, Spokane, WA 99208-6291 | 2010-08-24 |
| 1942513874 | Providence Health & Services - Washington | Internal Medicine | 212 E Central Ave, Suite 240, Spokane, WA 99208-6289 | 2010-07-20 |
| 1154648814 | Providence Physician Services Co | Family Medicine | 212 E Central Ave, Ste 440, Spokane, WA 99208-6291 | 2010-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043787161 | Bonnie Rose Spencer | Social Worker | E 44 Cozza, Spokane, WA 99208 | 2018-10-26 |
| 1235617515 | Melissa Dawn Scholl | Massage Therapist | 906 E Country Hill Ct, Spokane, WA 99208 | 2018-07-30 |
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1467943720 | Simone Ferguson | Student in an Organized Health Care Education/Training Program | 7808 North Morton Avenue, Apt. # 675, Spokane, WA 99208 | 2018-05-22 |
| 1912496035 | Ascend Network Corp | Counselor | 3711 W Woodside, Spokane, WA 99208 | 2018-05-03 |
| 1023522216 | Cherrywood Place-spokane, LLC | Assisted Living Facility | 100 East Dalke Ave, Spokane, WA 99208 | 2017-11-27 |
| 1881118792 | Annie Kamau | Registered Nurse | 5920 W Lonewolf, Spokane, WA 99208 | 2017-08-01 |
| 1609303908 | Jeffery Anthony Glinski | Counselor | 3754 W. Indian Trail Rd., Spokane, WA 99208 | 2017-05-17 |
| 1487186938 | Mukhlis Azar | Physical Therapy Assistant | 305 E Sierra Ct, Spokane, WA 99208 | 2017-04-03 |
| 1154796241 | Daisy O'dell | Marriage & Family Therapist | 515 W. Francis Ave., Suite #8, Spokane, WA 99208 | 2015-12-01 |
| Find all providers in zip 99208 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445150 | Healthy Bodies Nutrition | Dietitian, Registered | 12808 E Apache Pass Rd, Spokane, WA 99206-9309 | 2020-10-22 |
| 1558979369 | Rooted Nutrition Counseling | Dietitian, Registered | 1516 W Riverside Ave Ste 205, Spokane, WA 99201-1241 | 2020-07-17 |
| 1104457282 | Christine Marie Lowman | Dietitian, Registered | 910 W 5th Ave Ste 650, Spokane, WA 99204-2967 | 2020-01-28 |
| 1851939136 | Gloria Jean Treis | Dietitian, Registered | 4815 N Assembly St # Ms 120, Spokane, WA 99205-6197 | 2019-12-17 |
| 1639717226 | Rachel Alexandria Traylor | Dietitian, Registered | 1403 W 3rd Ave, Spokane, WA 99201-7023 | 2019-12-15 |
| 1992346514 | Amy Yeoman | Dietitian, Registered | 711 N Helena St Ste C, Spokane, WA 99202-2826 | 2019-10-04 |
| 1790254969 | Riley Allen Mccorkle | Dietitian, Registered | 101 W 8th Ave Ste 1100, Spokane, WA 99204-2307 | 2018-11-17 |
| 1942791850 | Margaret Eleacia Walser | Dietitian, Registered | 728 S Monroe St Apt 3, Spokane, WA 99204-3019 | 2018-05-25 |
| 1891283560 | Mikaela Carrillo | Dietitian, Registered | 2020 E 29th Ave Ste 210, Spokane, WA 99203-3950 | 2018-04-27 |
| 1629565759 | Rachel Robinson | Dietitian, Registered | 1212 N Washington St Ste 213, Spokane, WA 99201-2401 | 2018-04-14 |
| Find all providers in SPOKANE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.