Provider Demographics
NPI:1366896474
Name:FERRIS, MARGARET TERESE (SUDP)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:TERESE
Last Name:FERRIS
Suffix:
Gender:F
Credentials:SUDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 116TH AVE NE STE 302
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3811
Mailing Address - Country:US
Mailing Address - Phone:425-646-4406
Mailing Address - Fax:425-646-4409
Practice Address - Street 1:1515 116TH AVE NE STE 302
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3811
Practice Address - Country:US
Practice Address - Phone:425-646-4406
Practice Address - Fax:425-646-4409
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00001791101YA0400X
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACP00001791OtherWASHINGTON STATE DEPARTMENT OF HEALTH