Provider Demographics
NPI:1164015731
Name:PATTERSON, EMILY LANE
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:LANE
Last Name:PATTERSON
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 1:7 QUARTZ RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-7662
Mailing Address - Country:US
Mailing Address - Phone:517-731-4149
Mailing Address - Fax:
Practice Address - Street 1:7 QUARTZ RIDGE LN
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-7662
Practice Address - Country:US
Practice Address - Phone:360-217-9059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-15
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011089641041C0700X
WALW611481341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical