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General NPI Number Information
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NPI Number | 1730457615
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Entity Type | Organization
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Legal Business Name | BUILDING THE BRIDGES ORGANIZATION
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 7209 S PUGET SOUND AVE
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City | TACOMA
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State | WA
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Zip | 98409-3917
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Country | US
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Telephone | 253-576-5426
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Fax |
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Provider Business Mailing Address
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Address Line | 8001 SO HOSMER STREET STE C PMB 179
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City | TACOMA
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State | WA
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Zip | 98408
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Country | US
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Telephone | 253-576-5426
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DENNIS R TURNER
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Credential |
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Telephone | 25355765426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 27145200
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License Number State | WA
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