Provider Demographics
NPI:1760512883
Name:PATTERSON, JAMES ROBERT (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 S 1ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-3897
Mailing Address - Country:US
Mailing Address - Phone:360-422-7581
Mailing Address - Fax:360-422-7581
Practice Address - Street 1:17796 WALDEN LN
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-8161
Practice Address - Country:US
Practice Address - Phone:360-422-8191
Practice Address - Fax:360-422-8191
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003419101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health