Provider Demographics
NPI:1669785051
Name:FLOOD, PATRICIA A (LAC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:FLOOD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 E 8TH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-6251
Mailing Address - Country:US
Mailing Address - Phone:360-417-8870
Mailing Address - Fax:360-417-1873
Practice Address - Street 1:603 E 8TH ST
Practice Address - Street 2:SUITE E
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-6251
Practice Address - Country:US
Practice Address - Phone:360-417-8870
Practice Address - Fax:360-417-1873
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000166171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist