Provider Demographics
NPI:1003128083
Name:BARTSCH, EREN (LMT, CKTP)
Entity Type:Individual
Prefix:
First Name:EREN
Middle Name:
Last Name:BARTSCH
Suffix:
Gender:M
Credentials:LMT, CKTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 S BURLINGTON BLVD # 177
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-3223
Mailing Address - Country:US
Mailing Address - Phone:360-499-3324
Mailing Address - Fax:360-335-6881
Practice Address - Street 1:417 PEASE RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-3113
Practice Address - Country:US
Practice Address - Phone:360-499-3324
Practice Address - Fax:360-335-6881
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60175828225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist