Provider Demographics
NPI:1730362997
Name:BIHAG, BERTRAND TERRANCE (BA)
Entity type:Individual
Prefix:
First Name:BERTRAND
Middle Name:TERRANCE
Last Name:BIHAG
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 S SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2816
Mailing Address - Country:US
Mailing Address - Phone:253-627-2050
Mailing Address - Fax:
Practice Address - Street 1:514 S 13TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-1908
Practice Address - Country:US
Practice Address - Phone:253-396-5000
Practice Address - Fax:253-383-5548
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WARC00017752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor