Basic Information
| Provider Information | |||||||||
| NPI: | 1144985268 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GLENISTER | ||||||||
| FirstName: | BRIDGET | ||||||||
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| Mailing Information | |||||||||
| Address1: | PIONEER HUMAN SERVICES | ||||||||
| Address2: | 7440 W MARGINAL WAY S | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3608563186 | ||||||||
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| Practice Location | |||||||||
| Address1: | PIONEER CENTER NORTH | ||||||||
| Address2: | 1960 THOMPSON DR | ||||||||
| City: | SEDRO WOOLLEY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98284 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3608563186 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2021 | ||||||||
| LastUpdateDate: | 11/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.