Provider Demographics
NPI:1417173725
Name:LITTLEWOOD, PATRICIA K (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:K
Last Name:LITTLEWOOD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1507
Mailing Address - Street 2:
Mailing Address - City:EASTSOUND
Mailing Address - State:WA
Mailing Address - Zip Code:98245-1507
Mailing Address - Country:US
Mailing Address - Phone:360-376-3272
Mailing Address - Fax:
Practice Address - Street 1:374 NORTH BEACH ROAD
Practice Address - Street 2:SUITE 4-C
Practice Address - City:EASTSOUND
Practice Address - State:WA
Practice Address - Zip Code:98245-1507
Practice Address - Country:US
Practice Address - Phone:360-376-3272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001479103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA48373OtherREGENCEBLUESHIELD