Provider Demographics
NPI:1407908544
Name:ALLEN, PATRICIA ANN (ND)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6326 MARTIN WAY E STE 205
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-5561
Mailing Address - Country:US
Mailing Address - Phone:360-491-8877
Mailing Address - Fax:360-491-3052
Practice Address - Street 1:6326 MARTIN WAY E STE 205
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-5561
Practice Address - Country:US
Practice Address - Phone:360-491-8877
Practice Address - Fax:360-491-3052
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001082175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath