Provider Demographics
NPI:1922293513
Name:ONEILL, PATRICE JULIANN (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICE
Middle Name:JULIANN
Last Name:ONEILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:WA
Mailing Address - Zip Code:98249-0279
Mailing Address - Country:US
Mailing Address - Phone:360-331-5115
Mailing Address - Fax:360-331-7505
Practice Address - Street 1:1660 E LAYTON RD
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249
Practice Address - Country:US
Practice Address - Phone:360-331-5115
Practice Address - Fax:360-331-7505
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00013247207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1237770Medicaid
A05630315OtherDEA
WA1237770Medicaid