Provider Demographics
NPI:1982807608
Name:BERLIN, HERMANN (MS)
Entity type:Individual
Prefix:
First Name:HERMANN
Middle Name:
Last Name:BERLIN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 75541
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98175-0541
Mailing Address - Country:US
Mailing Address - Phone:206-919-5770
Mailing Address - Fax:206-362-3574
Practice Address - Street 1:4026 NE 55TH ST STE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-2264
Practice Address - Country:US
Practice Address - Phone:206-919-5770
Practice Address - Fax:206-362-3574
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001451106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist