=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669333209
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIFEPATH TRANSFORMATIONAL COACHING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/22/2025
-----------------------------------------------------
Last Update Date | 11/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 915 E SPRUCE ST UNIT 617
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98122-7067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-495-9659
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 915 E SPRUCE ST UNIT 617
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98122-7067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-495-9659
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HYPNOTHERAPIST
-----------------------------------------------------
Name | EVGENY BEREZIN
-----------------------------------------------------
Credential | CHT
-----------------------------------------------------
Telephone | 773-495-9659
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171400000X
-----------------------------------------------------
Taxonomy Name | Health & Wellness Coach
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------