Provider Demographics
NPI:1780418723
Name:BRIZARD, JOSE
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:BRIZARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIE JOSE
Other - Middle Name:
Other - Last Name:BRIZARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:20110 VASHON HWY SW
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-6026
Mailing Address - Country:US
Mailing Address - Phone:206-463-5511
Mailing Address - Fax:
Practice Address - Street 1:20110 VASHON HWY SW
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-6026
Practice Address - Country:US
Practice Address - Phone:206-463-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor