Provider Demographics
NPI:1790130854
Name:PATENAUDE, DAVID WILLIAM (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WILLIAM
Last Name:PATENAUDE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7530 164TH AVE NE
Mailing Address - Street 2:STE A240
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7821
Mailing Address - Country:US
Mailing Address - Phone:425-881-7790
Mailing Address - Fax:425-558-5676
Practice Address - Street 1:7530 164TH AVE NE
Practice Address - Street 2:STE A240
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7821
Practice Address - Country:US
Practice Address - Phone:425-881-7790
Practice Address - Fax:425-558-5676
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60641046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor