Healthcare Provider Details

I. General information

NPI: 1417310699
Provider Name (Legal Business Name): PATRICIA KUIPERS-DAWSON LMHC, LICSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA HANCOCK

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1498 SE TECH CENTER PL STE 300&130
VANCOUVER WA
98683-9591
US

IV. Provider business mailing address

3305 MAIN ST SUITE 009
VANCOUVER WA
98663
US

V. Phone/Fax

Practice location:
  • Phone: 360-619-2226
  • Fax:
Mailing address:
  • Phone: 360-241-9357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCG60648871
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61463342
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: