Provider Demographics
NPI:1780481242
Name:FERRE, BRISA (CBT)
Entity type:Individual
Prefix:
First Name:BRISA
Middle Name:
Last Name:FERRE
Suffix:
Gender:F
Credentials:CBT
Other - Prefix:
Other - First Name:BRISA
Other - Middle Name:
Other - Last Name:FERRE-BICANOVSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1885 SW MINA LN APT A103
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-4966
Mailing Address - Country:US
Mailing Address - Phone:808-387-1005
Mailing Address - Fax:
Practice Address - Street 1:600 STEWART ST STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1257
Practice Address - Country:US
Practice Address - Phone:808-387-1005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACB61668559103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst