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Contact Information

BRYAN L BERGHOUT, DPM
10821 19TH AVE SE
EVERETT, WA98208-5103
 Phone: 425-337-7000
 Fax: 425-338-2408
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for BRYAN L BERGHOUT · (Male)

NPI # 1255411419
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 10/16/2006
Last updated 02/05/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • WA License # PO00000813
  • WA Medicaid 8484388
Hospital affiliation(s)
  • PROVIDENCE REGIONAL MEDICAL CENTER EVERETT - (Acute Care)
    1321 COLBY AVENUE
    EVERETT, WA 98201
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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