# AUTHENTIC TRANSFORMATIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053855734
- **Authorized official:** DR. MARCEL ANTHONY VAN EERD (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (480) 277-5919

## Contact information

- **Practice address:** 1112 11TH ST STE 301, BELLINGHAM, WA 98225-6654
- **Practice address phone:** (360) 225-7073
- **Mailing address:** 3617 WESTHILLS PL, BELLINGHAM, WA 98226-4174
- **Mailing address phone:** (480) 277-5919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | PY60611766 | WA | Yes |

## Other

- **Enumeration date:** 12/14/2016
- **Last updated:** 12/14/2016