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General NPI Number Information
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NPI Number | 1902152184
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Entity Type | Individual
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Provider Name | MISTY DAWN BRIGHT LICSW
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Gender | Female
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | TRAVERSE THERAPY SERVICES, LLC 12507 BEL-RED RD., STE. 100
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City | BELLEVUE
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State | WA
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Zip | 98005-9800
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Country | US
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Telephone | 206-307-8422
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Fax |
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Provider Business Mailing Address
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Address Line | 3425 S 176TH ST UNIT 219
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City | SEATAC
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State | WA
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Zip | 98188-4038
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Country | US
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Telephone | 206-307-8432
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CG60148743
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License Number State | WA
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