Provider Demographics
NPI:1902388986
Name:RETTIG, PATRICK JOSEPH (LPC, LMHCA)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOSEPH
Last Name:RETTIG
Suffix:
Gender:M
Credentials:LPC, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10333 NE 1ST ST APT 664
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4062
Mailing Address - Country:US
Mailing Address - Phone:614-804-7341
Mailing Address - Fax:
Practice Address - Street 1:10827 NE 68TH ST STE C
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-4000
Practice Address - Country:US
Practice Address - Phone:614-804-7341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1700825101Y00000X
WAMC61023038101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor