Provider Demographics
NPI:1255738027
Name:PATLAN, SERVANDO BENJAMIN III (LMHC)
Entity type:Individual
Prefix:
First Name:SERVANDO
Middle Name:BENJAMIN
Last Name:PATLAN
Suffix:III
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 75TH PL SE APT 202
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-2706
Mailing Address - Country:US
Mailing Address - Phone:360-280-7062
Mailing Address - Fax:
Practice Address - Street 1:119 N COMMERCIAL ST STE 580
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4469
Practice Address - Country:US
Practice Address - Phone:360-280-7062
Practice Address - Fax:206-934-4229
Is Sole Proprietor?:No
Enumeration Date:2014-11-21
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60517538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health