Healthcare Provider Details

I. General information

NPI: 1194191171
Provider Name (Legal Business Name): PATRICIA KATHLEEN WARNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TRISH WARNER BAS AHP

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10521 MERIDIAN AVE N
SEATTLE WA
98133-9509
US

IV. Provider business mailing address

15903 3RD AVE NE
SHORELINE WA
98155-5713
US

V. Phone/Fax

Practice location:
  • Phone: 206-296-4990
  • Fax:
Mailing address:
  • Phone: 360-441-5215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number60582351
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: