Provider Demographics
NPI:1588836407
Name:FREW, PATRICIA MARIE (MD)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MARIE
Last Name:FREW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 DELAWARE LN
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1408
Mailing Address - Country:US
Mailing Address - Phone:360-566-4402
Mailing Address - Fax:
Practice Address - Street 1:7410 DELAWARE LN
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1408
Practice Address - Country:US
Practice Address - Phone:360-566-4402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ORMD154428207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program