Basic Information
| Provider Information | |||||||||
| NPI: | 1528557030 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRIBERG | ||||||||
| FirstName: | ABRAH | ||||||||
| MiddleName: | LORENA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4526 FEDERAL AVE # MS 11 | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982032132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253496200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4350 CORDATA PKWY # 100 | ||||||||
| Address2: | |||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982268278 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3609226670 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2018 | ||||||||
| LastUpdateDate: | 06/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.