Provider Demographics
NPI:1861959462
Name:STERN, BRET N (CP 60929929)
Entity type:Individual
Prefix:MR
First Name:BRET
Middle Name:N
Last Name:STERN
Suffix:
Gender:M
Credentials:CP 60929929
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10818 111TH CT NE APT O207
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-3848
Mailing Address - Country:US
Mailing Address - Phone:954-789-9454
Mailing Address - Fax:
Practice Address - Street 1:16225 NE 87TH ST STE A1
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3536
Practice Address - Country:US
Practice Address - Phone:954-789-9454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60929929101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)