Provider Demographics
NPI:1205374352
Name:BRINIGAR, VICTORIA (MS, MHP, LMHC, CDPT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:BRINIGAR
Suffix:
Gender:F
Credentials:MS, MHP, LMHC, CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 WELLS AVE S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2161
Mailing Address - Country:US
Mailing Address - Phone:206-408-5373
Mailing Address - Fax:425-226-6153
Practice Address - Street 1:221 WELLS AVE S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2161
Practice Address - Country:US
Practice Address - Phone:206-408-5373
Practice Address - Fax:425-226-6153
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60585396101YA0400X
WALH60717805101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)