Active NPI
Bruce Bartja Wachtel, LICSW
- Social Worker
- Seattle, WA
National Provider Identifier
1891890927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LICSW
- Practice address
- 1500 Fairview Ave E Ste 205
Seattle, WA 98102-3727 - Phone
- (206) 250-9166
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LICSW | WA | Primary |
Addresses
Primary practice location
1500 Fairview Ave E Ste 205
Seattle, WA 98102-3727
Mailing address
4111 Stone Way N Ste a
Seattle, WA 98103-8052
Phone (206) 250-9166
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LICSW | WA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522454400000",
"number": "1891890927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4111 STONE WAY N STE A",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981038052",
"telephone_number": "206-250-9166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 FAIRVIEW AVE E STE 205",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981023727",
"telephone_number": "206-250-9166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WACHTEL",
"first_name": "BRUCE",
"middle_name": "BARTJA",
"name_prefix": "Mr.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2018-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WA",
"license": "LICSW",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.