Healthcare Provider Details

I. General information

NPI: 1669389219
Provider Name (Legal Business Name): PATRICIA BARDINA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4649 SUNNYSIDE AVE N STE 520
SEATTLE WA
98103-6952
US

IV. Provider business mailing address

4649 SUNNYSIDE AVE N STE 520
SEATTLE WA
98103-6952
US

V. Phone/Fax

Practice location:
  • Phone: 206-580-3134
  • Fax:
Mailing address:
  • Phone: 206-580-3134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSYC.PY.61549770
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: