Provider Demographics
NPI:1003081787
Name:PATANO, JENNIFER (CNP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:PATANO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 W NICKERSON ST
Mailing Address - Street 2:APT. 3
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-1542
Mailing Address - Country:US
Mailing Address - Phone:917-858-6306
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:MS O.7.720
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-8949
Practice Address - Fax:206-987-8943
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY382057363LP0200X
NY004405171100000X
WAAP60332127363LP0200X
WAAC60340418171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No171100000XOther Service ProvidersAcupuncturist