Provider Demographics
NPI:1780943142
Name:MCGINNIS, PATIENCE BOWLES (PSYD)
Entity type:Individual
Prefix:
First Name:PATIENCE
Middle Name:BOWLES
Last Name:MCGINNIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 D STREET
Mailing Address - Street 2:UNIT 202
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225
Mailing Address - Country:US
Mailing Address - Phone:503-475-0534
Mailing Address - Fax:
Practice Address - Street 1:1817 D ST
Practice Address - Street 2:UNIT 202
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3228
Practice Address - Country:US
Practice Address - Phone:503-475-0534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPSYC.PY.60089682103TC0700X
OR2061103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical