Provider Demographics
NPI:1467993592
Name:STUTZMAN, PATRICIA (CBT, RBT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:STUTZMAN
Suffix:
Gender:F
Credentials:CBT, RBT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1003 7TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033
Mailing Address - Country:US
Mailing Address - Phone:425-658-3017
Mailing Address - Fax:
Practice Address - Street 1:1003 7TH AVENUE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033
Practice Address - Country:US
Practice Address - Phone:425-658-3016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician