Provider Demographics
NPI:1275803199
Name:BRIDGEWAY TREATMENT SERVICES, L.L.C.
Entity Type:Organization
Organization Name:BRIDGEWAY TREATMENT SERVICES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSW, LSWAIC, CDP
Authorized Official - Phone:425-232-8003
Mailing Address - Street 1:410 BELLEVUE WAY SE
Mailing Address - Street 2:SUITE 02
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6672
Mailing Address - Country:US
Mailing Address - Phone:425-238-5315
Mailing Address - Fax:425-283-5247
Practice Address - Street 1:410 BELLEVUE WAY SE
Practice Address - Street 2:SUITE 02
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6672
Practice Address - Country:US
Practice Address - Phone:425-238-5315
Practice Address - Fax:425-283-5247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA17-1137-000251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health