Provider Demographics
NPI:1679678114
Name:PATTON, DANYA M (CDP)
Entity Type:Individual
Prefix:MRS
First Name:DANYA
Middle Name:M
Last Name:PATTON
Suffix:
Gender:F
Credentials:CDP
Other - Prefix:MISS
Other - First Name:DANYA
Other - Middle Name:M
Other - Last Name:MICHAELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:512 NE 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-1353
Mailing Address - Country:US
Mailing Address - Phone:360-834-4298
Mailing Address - Fax:
Practice Address - Street 1:12607 SE MILL PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6055
Practice Address - Country:US
Practice Address - Phone:360-891-6274
Practice Address - Fax:360-896-4478
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00002579101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)