Provider Demographics
NPI:1033781968
Name:BRIDGES FORWARD
Entity Type:Organization
Organization Name:BRIDGES FORWARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELIA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:TINNIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-528-6374
Mailing Address - Street 1:7 W 49TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-4446
Mailing Address - Country:US
Mailing Address - Phone:509-528-6374
Mailing Address - Fax:
Practice Address - Street 1:7 W 49TH AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99337-4446
Practice Address - Country:US
Practice Address - Phone:509-528-6374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty