Provider Demographics
NPI:1265647440
Name:AN, PATI (PT)
Entity Type:Individual
Prefix:
First Name:PATI
Middle Name:
Last Name:AN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:WILCOX
Other - Last Name:TROLANDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12811 8TH AVE WEST
Mailing Address - Street 2:A205
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-6335
Mailing Address - Country:US
Mailing Address - Phone:425-348-1259
Mailing Address - Fax:425-348-3071
Practice Address - Street 1:12811 8TH AVE WEST
Practice Address - Street 2:A205
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-6335
Practice Address - Country:US
Practice Address - Phone:425-348-1259
Practice Address - Fax:425-348-3071
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000072652251X0800X
MAPT87722251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic