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NPI Code Detail

MEDICARE: MS. SUSANNA DOROTHY PATTON BS

MEDICARE: MS. SUSANNA DOROTHY PATTON BS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorLH61201631WA
2101YM0800XMental Health CounselorWA

General Provider Information

NPI Number : 1720396286
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSANNA DOROTHY PATTON BS
Provider Business Mailing Address
First Line : 1498 SE TECH CENTER PL STE 300
Second Line :
City : VANCOUVER
State : WA
Zip : 98683-5509
Country : US
Telephone Number : 360-567-2200
Fax Number : 360-567-2212
Provider Business Practice Location Address
First Line : 1498 SE TECH CENTER PL STE 300
Second Line :
City : VANCOUVER
State : WA
Zip : 98683-5509
Country : US
Telephone Number : 360-984-7040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2010
Last Update Date : 04/01/2025

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