Provider Demographics
NPI:1326364977
Name:ABBOTT, PATTI GENE (LMP)
Entity Type:Individual
Prefix:MS
First Name:PATTI
Middle Name:GENE
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3074 SW AVALON WAY APT 1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-2676
Mailing Address - Country:US
Mailing Address - Phone:206-909-9224
Mailing Address - Fax:
Practice Address - Street 1:3074 SW AVALON WAY APT 1
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-2676
Practice Address - Country:US
Practice Address - Phone:206-909-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00017597174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist