JACOB TYRELL BERG (NPI# 1538724455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538724455 |
| Entity Type | Individual |
| Full Name | JACOB TYRELL BERG |
| Practice Address |
7711 S Sunnycrest Rd Seattle WA 98178-2749 |
| Practice Telephone | 3076309380 |
| Mailing Telephone | 3076309380 |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2019-05-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
7711 S SUNNYCREST RD |
| City | SEATTLE |
| State | WA |
| Zip Code | 98178-2749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861057796 | Rachel Leigh Visconti | Student in an Organized Health Care Education/Training Program | 7711 S Sunnycrest Rd, Seattle, WA 98178-2749 | 2019-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417474990 | Jerid Norbert Stevenot | Occupational Therapist | 12037 80th Ave S, Seattle, WA 98178 | 2017-08-25 |
| 1518203785 | Pioneer Human Services | Substance Abuse Rehabilitation Facility | 11900 Beacon Avenue S., Seattle, WA 98178 | 2012-12-17 |
| 1740514439 | Jae Lyung Hur | Dentist | 7632 S 126th St., Seattle, WA 98178 | 2009-09-28 |
| 1649411190 | Premier Nursing Care Agency | Registered Nurse | 5707 South Augusta St, Seattle, WA 98178 | 2009-03-13 |
| 1861641177 | Bonnie M Lee | Massage Therapist | 10460 Waters Ave S., Seattle, WA 98178 | 2008-09-10 |
| 1558424473 | Planned Parenthood of The Great Northwest and The Hawaiian Islands | Clinic/Center | 2001 East Madison Street, Seattle, WA 98178 | 2006-12-19 |
| 1689787913 | Brian Wilhoi Chan | Chiropractor | 12419 Rentan Ave S, Seattle, WA 98178 | 2006-08-17 |
| 1780110106 | Rachael Bowler | Student in an Organized Health Care Education/Training Program | 12430 83rd Ave S, Seattle, WA 98178 | 2017-05-04 |
| 1508392937 | Tam Pham | Behavior Technician | 12430 83rd Ave S, Seattle, WA 98178 | 2017-05-04 |
| 1093241424 | Brenda Taylor | Behavior Technician | 12430 83rd Ave S, Seattle, WA 98178 | 2017-05-04 |
| Find all providers in zip 98178 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342358 | Emma Peconga | Student in an Organized Health Care Education/Training Program | 3619 Ashworth Ave N, Seattle, WA 98103-8116 | 2020-10-02 |
| 1780290361 | Compassionate Peer Counseling LLC | Student in an Organized Health Care Education/Training Program | 3250 Airport Way S Ste 608, Seattle, WA 98134-2172 | 2020-09-19 |
| 1336751684 | Binabahen Shah | Student in an Organized Health Care Education/Training Program | 6035 4th Ave Nw, Seattle, WA 98107-2109 | 2020-08-18 |
| 1316558968 | Jimmy Nguyen | Student in an Organized Health Care Education/Training Program | 5525 23rd Ave S, Seattle, WA 98108-2918 | 2020-08-16 |
| 1174133672 | Selomie Habtemichael | Student in an Organized Health Care Education/Training Program | 10000 30th Ave Sw, Seattle, WA 98146-3720 | 2020-08-09 |
| 1659980720 | Joseph Banham | Student in an Organized Health Care Education/Training Program | 12057 Lakeside Pl Ne, Seattle, WA 98125-5956 | 2020-07-24 |
| 1326662396 | Dale Justin Podolsky | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Ob.9.520, Seattle Children's, Seattle, WA 98105 | 2020-06-04 |
| 1659993723 | Caroline Mullins | Student in an Organized Health Care Education/Training Program | 701 N 36th St Ste 3000, Seattle, WA 98103-8868 | 2020-05-12 |
| 1730700741 | Christian Van Rooyen | Student in an Organized Health Care Education/Training Program | 1951 Pacific Street, Seattle, WA 98195 | 2020-04-30 |
| 1669092128 | Ahmed Abdelrazek | Student in an Organized Health Care Education/Training Program | 1959 Ne Pacific Street, 356560, Department of Psychiart, Seattle, WA 98195-6560 | 2020-04-24 |
| Find all providers in SEATTLE | ||||
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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.