Organization
ENGAGING MINDFULNESS FORGING MEANING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE BARTJA WACHTEL LICSW, MHP, CMHS (OWNER, SOLE MEMBER, AGENT)
(206) 250-9166
Entity
Organization
Contact information
Practice address
1500 FAIRVIEW AVE E STE 205, SEATTLE, WA 98102-3727
(206) 250-9166
Mailing address
4111 STONE WAY N STE A, SEATTLE, WA 98103-8052
(206) 250-9166
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
603534700
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891890927
SOLE PROVIDER NPI
WA
01
—
LW00008447
WASHINGTON STATE DEPARTMENT OF HEALTH SOCIAL WORKER LICENSE NUMBER
WA
Enumeration date
03/31/2018
Last updated
03/31/2018
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