Provider Demographics
NPI:1164853289
Name:PATTERSON, KAMBERA (MS, LMHCA, NCC)
Entity Type:Individual
Prefix:
First Name:KAMBERA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MS, LMHCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1992 ADVANTAGE AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-2009
Mailing Address - Country:US
Mailing Address - Phone:360-271-1075
Mailing Address - Fax:
Practice Address - Street 1:9119 RIDGETOP BLVD NW
Practice Address - Street 2:#220
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8549
Practice Address - Country:US
Practice Address - Phone:360-908-2268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-30
Last Update Date:2013-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60415286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health