Provider Demographics
NPI:1114309762
Name:BARNES, PATRICIA RENA (AAS, CDPT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:RENA
Last Name:BARNES
Suffix:
Gender:F
Credentials:AAS, CDPT
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:RENA
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AAS, CDPT
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:1600 E OLIVE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2735
Practice Address - Country:US
Practice Address - Phone:206-302-2200
Practice Address - Fax:206-302-2210
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO-60382401390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program