Provider Demographics
NPI:1487404844
Name:GEBRE, BERHAN NAWID (CBT)
Entity type:Individual
Prefix:
First Name:BERHAN
Middle Name:NAWID
Last Name:GEBRE
Suffix:
Gender:F
Credentials:CBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16825 48TH AVE W STE 334
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-6408
Mailing Address - Country:US
Mailing Address - Phone:425-293-2557
Mailing Address - Fax:
Practice Address - Street 1:16825 48TH AVE W STE 334
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-6408
Practice Address - Country:US
Practice Address - Phone:425-293-2557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACBT.CB.61541123106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician