Healthcare Provider Details

I. General information

NPI: 1649250408
Provider Name (Legal Business Name): NATHAN RONAL PATTERSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL OAK HARBOR 3475 N. SARATOGA ST
OAK HARBOR WA
98278-0001
US

IV. Provider business mailing address

10553 SIROCCO CIR NW
SILVERDALE WA
98383-8810
US

V. Phone/Fax

Practice location:
  • Phone: 360-257-2301
  • Fax:
Mailing address:
  • Phone: 360-308-0346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE00009456
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: