Provider Demographics
NPI:1407576622
Name:DAVIS, PATRICIA MARIE (MSW, LMHC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSW, LMHC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:M
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LMHC
Mailing Address - Street 1:2307 WALNUT AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2039
Mailing Address - Country:US
Mailing Address - Phone:206-305-3390
Mailing Address - Fax:
Practice Address - Street 1:2307 WALNUT AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-2039
Practice Address - Country:US
Practice Address - Phone:206-305-3390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60147056101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health