Provider Demographics
NPI:1134158033
Name:WORTHEY, PATRICIA ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:WORTHEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:WORTHEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:144 RAILROAD AVE STE 227
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-4100
Mailing Address - Country:US
Mailing Address - Phone:206-669-4328
Mailing Address - Fax:888-423-4818
Practice Address - Street 1:144 RAILROAD AVE STE 227
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-4100
Practice Address - Country:US
Practice Address - Phone:206-669-4328
Practice Address - Fax:888-423-4818
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1812103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical