Healthcare Provider Details

I. General information

NPI: 1508727272
Provider Name (Legal Business Name): EVGENY BEREZIN CHT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: EUGENE BEREZIN CHT

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 E SPRUCE ST UNIT 617
SEATTLE WA
98122-7067
US

IV. Provider business mailing address

915 E SPRUCE ST UNIT 617
SEATTLE WA
98122-7067
US

V. Phone/Fax

Practice location:
  • Phone: 773-495-9659
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: