Provider Demographics
NPI:1245391390
Name:WILLIAMS, PATRICK C (PA)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:500 LILLY RD NE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5197
Mailing Address - Country:US
Mailing Address - Phone:360-413-8250
Mailing Address - Fax:360-413-8830
Practice Address - Street 1:500 LILLY RD NE
Practice Address - Street 2:SUITE 204
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5197
Practice Address - Country:US
Practice Address - Phone:360-413-8250
Practice Address - Fax:360-413-8830
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2014-12-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
WAPA60434156363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant