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NPI Code Detail

MEDICARE: DAVID JOHNATHON PATRICK ATC

MEDICARE: DAVID JOHNATHON PATRICK ATC
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
12255A2300XAthletic Trainer
2225100000XPhysical TherapistPT60466589WA

General Provider Information

NPI Number : 1659498293
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID JOHNATHON PATRICK ATC
Provider Business Mailing Address
First Line : 1218 3RD AVE STE 104
Second Line :
City : SEATTLE
State : WA
Zip : 98101-3008
Country : US
Telephone Number : 206-447-2220
Fax Number : 206-447-2228
Provider Business Practice Location Address
First Line : 1218 3RD AVE STE 104
Second Line :
City : SEATTLE
State : WA
Zip : 98101-3008
Country : US
Telephone Number : 206-447-2220
Fax Number : 206-447-2228
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 09/18/2014

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Directions to “ DAVID JOHNATHON PATRICK ATC” Practice Location

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