Provider Demographics
NPI:1063495018
Name:FRANCE, PATRICIA MICHELLE (LICSW, CDP, BCD)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MICHELLE
Last Name:FRANCE
Suffix:
Gender:F
Credentials:LICSW, CDP, BCD
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:MICHELLE
Other - Last Name:FRANCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW, CDP, BCD
Mailing Address - Street 1:69 BONNEY ST
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-1501
Mailing Address - Country:US
Mailing Address - Phone:253-495-0843
Mailing Address - Fax:
Practice Address - Street 1:VA PUGET SOUND HEALTH CARE SYSTEM
Practice Address - Street 2:9600 VETERANS DRIVE
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-9500
Practice Address - Country:US
Practice Address - Phone:253-583-3568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 602761261041C0700X
WACP 602296160101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)