Provider Demographics
NPI:1073203345
Name:PACATTE, ILANIA RHIANNON
Entity Type:Individual
Prefix:
First Name:ILANIA
Middle Name:RHIANNON
Last Name:PACATTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21120 MERIDIAN E
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-8254
Mailing Address - Country:US
Mailing Address - Phone:253-904-5565
Mailing Address - Fax:
Practice Address - Street 1:21120 MERIDIAN E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-8254
Practice Address - Country:US
Practice Address - Phone:253-904-5565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No104100000XBehavioral Health & Social Service ProvidersSocial Worker