Provider Demographics
NPI:1790832418
Name:FERREIRA, TRISH ANN (LICSW, CDP)
Entity Type:Individual
Prefix:
First Name:TRISH
Middle Name:ANN
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:LICSW, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 41ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2023
Mailing Address - Country:US
Mailing Address - Phone:206-499-7623
Mailing Address - Fax:
Practice Address - Street 1:19655 1ST AVE S
Practice Address - Street 2:STE 206
Practice Address - City:NORMANDY PARK
Practice Address - State:WA
Practice Address - Zip Code:98148-2172
Practice Address - Country:US
Practice Address - Phone:206-499-7623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000081931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
8803050Medicare ID - Type Unspecified