Provider Demographics
NPI:1821293895
Name:READY, PATRICIA A (PHD)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:READY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:
Other - Last Name:READY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 22193
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-0193
Mailing Address - Country:US
Mailing Address - Phone:206-661-6925
Mailing Address - Fax:
Practice Address - Street 1:515 28TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4146
Practice Address - Country:US
Practice Address - Phone:206-661-6925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023159225700000X
WAPY60238402103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00023159OtherMASSAGE LICENSE NUMBER
WA0218241OtherL & I PAYEE NUMBER
WAPY60238402OtherDEPARTMENT OF HEALTH, WASHINGTON STATE