Provider Demographics
NPI:1376625590
Name:VAN DUINE, PATRICE MARIE (ARNP, MED, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICE
Middle Name:MARIE
Last Name:VAN DUINE
Suffix:
Gender:F
Credentials:ARNP, MED, PMHNP-BC
Other - Prefix:
Other - First Name:PATRICE
Other - Middle Name:MARIE
Other - Last Name:BORER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2722 COLBY AVE STE 328
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3531
Mailing Address - Country:US
Mailing Address - Phone:425-740-3600
Mailing Address - Fax:425-740-3601
Practice Address - Street 1:2722 COLBY AVE. STE #328
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3557
Practice Address - Country:US
Practice Address - Phone:425-740-3600
Practice Address - Fax:425-740-3601
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00059378163WP0807X, 163WP0808X, 163WP0809X
WAAP30007518363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
11958223OtherCAQH
WAAP30007518OtherWA DEPT. OF HEALTH
WARN00059378OtherWA DEPT. OF HEALTH
WA9659749Medicaid