Provider Demographics
NPI:1467898072
Name:PASTERNAK, PATRICIA LEE (LMFT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LEE
Last Name:PASTERNAK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8515 NE HAZEL DELL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8144
Mailing Address - Country:US
Mailing Address - Phone:360-949-7606
Mailing Address - Fax:
Practice Address - Street 1:8515 NE HAZEL DELL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8144
Practice Address - Country:US
Practice Address - Phone:360-949-7606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60300384106H00000X
CA40541106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist