Provider Demographics
NPI:1073549002
Name:PATZ, JOHN D (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:PATZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:14841 179TH AVE SE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1127
Mailing Address - Country:US
Mailing Address - Phone:360-217-1155
Mailing Address - Fax:360-217-1154
Practice Address - Street 1:14841 179TH AVE SE
Practice Address - Street 2:SUITE 210
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1127
Practice Address - Country:US
Practice Address - Phone:360-217-1155
Practice Address - Fax:360-217-1154
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAOP00001308207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8857396Medicare ID - Type Unspecified
WAG8877613Medicare PIN
WA8803198Medicare PIN
E^3656Medicare UPIN