Provider Demographics
NPI:1003230152
Name:MADDISON, PATRICK HARLAN
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:HARLAN
Last Name:MADDISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 MILWAUKEE
Mailing Address - Street 2:102
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-3028
Mailing Address - Country:US
Mailing Address - Phone:406-531-5450
Mailing Address - Fax:
Practice Address - Street 1:1690 MILWAUKEE
Practice Address - Street 2:102
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-3028
Practice Address - Country:US
Practice Address - Phone:406-531-5450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker