Healthcare Provider Details

I. General information

NPI: 1699851774
Provider Name (Legal Business Name): PATRICK LAMORRIS HYERS RN, MHA, BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AMERICAN LAKE VA- NURSING EXECUTIVE OFFICE 9600 VETERANS DR
TACOMA WA
98493-0001
US

IV. Provider business mailing address

15128 SILCOX DR SW
LAKEWOOD WA
98498-1037
US

V. Phone/Fax

Practice location:
  • Phone: 253-582-8440
  • Fax:
Mailing address:
  • Phone: 253-380-3021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN00125389
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: