Provider Demographics
NPI:1477595650
Name:HINES, PATRICIA MARY (MENTAL HEALTH PROFES)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MARY
Last Name:HINES
Suffix:
Gender:F
Credentials:MENTAL HEALTH PROFES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23821 135TH DR SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-3995
Mailing Address - Country:US
Mailing Address - Phone:360-668-7179
Mailing Address - Fax:
Practice Address - Street 1:3322 BROADWAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4425
Practice Address - Country:US
Practice Address - Phone:425-349-8195
Practice Address - Fax:425-349-6805
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00016277101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health