Provider Demographics
NPI:1891779682
Name:PATRICK, GRAHAM JAMES (PHD, ARNP)
Entity Type:Individual
Prefix:DR
First Name:GRAHAM
Middle Name:JAMES
Last Name:PATRICK
Suffix:
Gender:M
Credentials:PHD, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11083 HORIZON LANE WEST SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-8159
Mailing Address - Country:US
Mailing Address - Phone:360-874-1175
Mailing Address - Fax:
Practice Address - Street 1:502 HIGH ST
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-4716
Practice Address - Country:US
Practice Address - Phone:360-874-0444
Practice Address - Fax:360-874-0037
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004779163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health