Provider Demographics
NPI:1558687418
Name:STARR, PATRICIA L (MA)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:L
Last Name:STARR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 LAKE BELLEVUE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2478
Mailing Address - Country:US
Mailing Address - Phone:425-417-0877
Mailing Address - Fax:
Practice Address - Street 1:40 LAKE BELLEVUE DR STE 250
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2478
Practice Address - Country:US
Practice Address - Phone:425-417-0877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 00006834101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health