Healthcare Provider Details

I. General information

NPI: 1831400175
Provider Name (Legal Business Name): PATRICE BISHOP LICSW, LMHC, SUDP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32473 22ND AVE SW
FEDERAL WAY WA
98023-2503
US

IV. Provider business mailing address

32473 22ND AVE SW
FEDERAL WAY WA
98023-2503
US

V. Phone/Fax

Practice location:
  • Phone: 602-341-7352
  • Fax:
Mailing address:
  • Phone: 602-341-7352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP00003600
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00008156
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLW60174881
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: