Basic Information
| Provider Information | |||||||||
| NPI: | 1487184461 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARRERA | ||||||||
| FirstName: | TERESITA | ||||||||
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| Credential: | MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3121 S 216TH ST APT 3 | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981986003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065654118 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3639 MARTIN LUTHER KING JR WAY S | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981446847 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2066957600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2017 | ||||||||
| LastUpdateDate: | 06/13/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.