Provider Demographics
NPI:1811604481
Name:PERRY, PATRICIA EILEEN
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:EILEEN
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PATTY
Other - Middle Name:EILEEN
Other - Last Name:PERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NICKNAME
Mailing Address - Street 1:581 SE FIREWEED RD
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-7615
Mailing Address - Country:US
Mailing Address - Phone:360-427-0202
Mailing Address - Fax:844-890-6022
Practice Address - Street 1:581 SE FIREWEED RD
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-7615
Practice Address - Country:US
Practice Address - Phone:360-427-0202
Practice Address - Fax:844-890-6022
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)