Provider Demographics
NPI:1225659808
Name:BARRY, PATRICK MICHAEL (LMFT)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:MICHAEL
Last Name:BARRY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 481
Mailing Address - Street 2:
Mailing Address - City:KEYPORT
Mailing Address - State:WA
Mailing Address - Zip Code:98345-0481
Mailing Address - Country:US
Mailing Address - Phone:253-651-6545
Mailing Address - Fax:
Practice Address - Street 1:7500 OLD MILITARY RD NE STE 103
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-3242
Practice Address - Country:US
Practice Address - Phone:360-698-9258
Practice Address - Fax:360-698-9296
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF61163947106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist