Provider Demographics
NPI:1841585478
Name:NEWMAN, PATRICK (LMP)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7813 NE HARBOR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-7783
Mailing Address - Country:US
Mailing Address - Phone:360-509-4073
Mailing Address - Fax:
Practice Address - Street 1:7813 NE HARBOR VIEW DR
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7783
Practice Address - Country:US
Practice Address - Phone:360-509-4073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-11
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60228955225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist