KENNETH S BERGMAN (NPI# 1669443032) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669443032 |
| Entity Type | Individual |
| Full Name | KENNETH S BERGMAN |
| Credential | MD |
| Practice Address |
11511 Canterwood Blvd Nw Suite 50 Gig Harbor WA 98332-5813 |
| Mailing Address |
314 Mlk Jr Way Ste 11 Tacoma WA 98405 |
| Practice Telephone | 2538515155 |
| Practice Fax Number | 2538515367 |
| Mailing Telephone | 2536276172 |
| Mailing Fax Number | 2536278792 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2012-08-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
MD00030100 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8293987 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013912252 | Kenneth Robert Bergman | Allergy & Immunology | 13890 Braddock Rd, Ste 206, Centreville, VA 20121-2437 | 2005-06-15 |
| 1659349447 | Kenneth R Bergman Jr. | Otolaryngology | 14631 Lee Hwy, Ste 413, Centreville, VA 20121-5824 | 2006-03-09 |
| Street Address |
11511 CANTERWOOD BLVD NW SUITE 50 |
| City | GIG HARBOR |
| State | WA |
| Zip Code | 98332-5813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952306037 | Lance Lebrecht Bear | Orthopaedic Surgery | 11511 Canterwood Blvd Nw, Ste 205, Gig Harbor, WA 98332-5813 | 2005-06-16 |
| 1508343369 | Melanie Refuerzo | Occupational Therapist | 11511 Canterwood Blvd Nw, Gig Harbor, WA 98332-5813 | 2018-07-25 |
| 1275029621 | Melissa Renee Means | Registered Nurse | 11511 Canterwood Blvd Nw, Gig Harbor, WA 98332 | 2018-07-09 |
| 1104362490 | Mh Wellness & Acupuncture Studio | Acupuncturist | 11511 Canterwood Blvd Nw, Ste 40, Gig Harbor, WA 98332-5813 | 2017-01-11 |
| 1528443827 | Jamie Kathleen Mullen | Chiropractor | 11511 Canterwood Blvd Nw, Ste 210, Gig Harbor, WA 98332-5818 | 2015-07-28 |
| 1740667955 | Franciscan Health System | Genetic Counselor, MS | 11511 Canterwood Blvd Nw, Ste 45, Gig Harbor, WA 98332-5813 | 2015-04-27 |
| 1821363300 | Franciscan Health System | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11511 Canterwood Blvd Nw, Suite 50, Gig Harbor, WA 98332-5813 | 2012-03-15 |
| 1215200977 | Franciscan Health System | Registered Nurse | 11511 Canterwood Blvd Nw, Suite 220, Gig Harbor, WA 98332-5813 | 2012-02-10 |
| 1871888933 | Franciscan Medical Group | Internal Medicine | 11511 Canterwood Blvd Nw, Ste 110, Gig Harbor, WA 98332-5813 | 2011-06-16 |
| 1801181243 | Franciscan Medical Group | Surgery | 11511 Canterwood Blvd Nw, Suite 145, Gig Harbor, WA 98332-5813 | 2011-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023584125 | William Edmondson Wells | Counselor | Wccw, 9601 Bujacick Rd. Nw, Gig Harbor, WA 98332 | 2018-10-17 |
| 1417446758 | Janelle Elizabeth Becker | Physician Assistant | 11511 Canterwood Blvd Nw Ste 205, Gig Harbor, WA 98332 | 2018-05-02 |
| 1205252046 | Jenny Wical | Registered Nurse | 12201 Osprey Dr. Nw, Gig Harbor, WA 98332 | 2014-03-17 |
| 1134486616 | Jacinda Leigh Pickett | Pharmacist | 10990 Harbor Hill Dr, Gig Harbor, WA 98332 | 2012-04-20 |
| 1114242898 | Michael Robert Conger | Urology | 9704 Woodworth Ave Nw, Gig Harbor, WA 98332 | 2010-04-06 |
| 1346473899 | Robert Howard Lerman | Internal Medicine | 9770 44th Ave Nw, Suite 102, Gig Harbor, WA 98332 | 2009-09-01 |
| 1447406699 | Franciscan Health System | General Acute Care Hospital | 11567 Canterwood Blvd, Gig Harbor, WA 98332 | 2008-08-07 |
| 1730303249 | Richard Mason Coyner | Dentist | 7715 Pioneer Way, Gig Harbor, WA 98332 | 2007-04-13 |
| 1902978711 | Byron D Fenton | Chiropractor | 14619 Purdy Dr, Gig Harbor, WA 98332 | 2006-11-15 |
| 1063515351 | Gordon Bernstein | Radiology | 5304 W Old Stump Dr Nw, Gig Harbor, WA 98332 | 2006-09-05 |
| Find all providers in zip 98332 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487625851 | Dean G Mastras | Radiology | 11511 Canterwood Blvd Ste 50, Gig Harbor, WA 98332-5816 | 2006-02-01 |
| 1366694796 | Peninsula Rad Onc Ctr LLC | Radiology | 11511 Canterwood Blvd Ste 50, Gig Harbor, WA 98332-5816 | 2008-10-16 |
| 1477524841 | Michael J Mcdonough | Radiology | 11511 Canterwood Blvd Ste 50, Gig Harbor, WA 98332-5816 | 2006-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669829289 | Rosanna Hoi Lam Yeung | Radiology | 12040 Ne 128th St # Ms -63, Kirkland, WA 98034 | 2016-05-24 |
| 1508251000 | Anthony Hoai-nam Pham | Radiology | 19917 7th Ave Ne Ste 100, Poulsbo, WA 98370-6555 | 2015-04-01 |
| 1841603479 | Sherry Zhao | Radiology | 7350 W Deschutes Ave Ste A, Kennewick, WA 99336 | 2014-06-11 |
| 1467877670 | John Paul Lytle Jr. | Radiology | 6729 204th Dr. Ne, Redmond, WA 98053 | 2014-02-25 |
| 1962824219 | The Polyclinic | Radiology | 1225 Madison St, Seattle, WA 98104-1336 | 2014-01-06 |
| 1720356090 | Herbert Carl Berry | Radiology | 65 E. Roanoke St., Seattle, WA 98102 | 2011-12-01 |
| 1609175660 | Legacy Salmon Creek Hospital | Radiology | 2121 Ne 139th St Ste 100, Vancouver, WA 98686-2316 | 2011-03-16 |
| 1861794992 | Thomas Ward Griffin | Radiology | 3620 E Prospect St, Seattle, WA 98112-4440 | 2010-11-22 |
| 1407170467 | Aaron Shingo Kusano | Radiology | 1959 Ne Pacific St. Box 356043, University of Washington Department of Radiation Oncolo, Seattle, WA 98195 | 2010-03-19 |
| 1184866527 | Justin William Suszko | Radiology | 4525 3rd Ave Se Ste 100, Lacey, WA 98503-1010 | 2009-03-31 |
| Find all providers with the same taxonomy | ||||
| City | GIG HARBOR |
| Zip Code | 98332 |
Please comment or provide details below to improve the information on KENNETH S BERGMAN.
| 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.