Provider Demographics
NPI:1033650361
Name:BRUNO, FRANK MICHAEL (LMFTA)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:MICHAEL
Last Name:BRUNO
Suffix:
Gender:M
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4726 172ND CT SE # 300
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5819
Mailing Address - Country:US
Mailing Address - Phone:425-625-9102
Mailing Address - Fax:
Practice Address - Street 1:300 NE GILMAN BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2941
Practice Address - Country:US
Practice Address - Phone:425-625-9102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WA60842867106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor