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NPI Code Detail

MEDICARE: COY PATRAS

MEDICARE: COY PATRAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorRC00031952WA

General Provider Information

NPI Number : 1548302755
Entity Type Code : Individual
Provider Name (Legal Business Name) : COY PATRAS
Provider Business Mailing Address
First Line : 7411 E OREGON RD
Second Line :
City : ELK
State : WA
Zip : 99009-8714
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 210 W SPRAGUE AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99201-3627
Country : US
Telephone Number : 509-747-8224
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/08/2007

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1720134992 — MISS HEIKE A B LAKE M.ED, LSW
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1427190669 — MS. JO ANN WORTHINGTON
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Directions to “ COY PATRAS ” Practice Location

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