Provider Demographics
NPI:1073589560
Name:BRIDGEWAYS
Entity Type:Organization
Organization Name:BRIDGEWAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR OF CLINICAL QI
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRARO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:425-513-8213
Mailing Address - Street 1:5801 23RD DR W #104
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203
Mailing Address - Country:US
Mailing Address - Phone:425-513-8213
Mailing Address - Fax:425-513-0534
Practice Address - Street 1:5801 23RD DR W #104
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203
Practice Address - Country:US
Practice Address - Phone:425-513-8213
Practice Address - Fax:425-513-0534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00008041104100000X
251S00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA115118000Medicare ID - Type Unspecified