Healthcare Provider Details

I. General information

NPI: 1508778028
Provider Name (Legal Business Name): SPENCER DALE PATTERSON PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 S 9TH AVE
SEQUIM WA
98382-3697
US

IV. Provider business mailing address

1571 12TH ST
PORT TOWNSEND WA
98368-8531
US

V. Phone/Fax

Practice location:
  • Phone: 360-681-5650
  • Fax:
Mailing address:
  • Phone: 360-301-6109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP.AP.70162594-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: