Provider Demographics
NPI:1992905657
Name:BERGER, CIERRA J (LMP)
Entity type:Individual
Prefix:MRS
First Name:CIERRA
Middle Name:J
Last Name:BERGER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:CIERRA
Other - Middle Name:J
Other - Last Name:TURK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:8009 72ND DR NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-7890
Mailing Address - Country:US
Mailing Address - Phone:425-971-7496
Mailing Address - Fax:
Practice Address - Street 1:8009 72ND DR NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-7890
Practice Address - Country:US
Practice Address - Phone:425-971-7496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012463225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA136666OtherDEPARTMENT OF LABOR & IND