Provider Demographics
NPI:1831525278
Name:FAKER-BOYLE, PATRICE ANNETTE (MA, LMHC)
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:ANNETTE
Last Name:FAKER-BOYLE
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:PATRICE
Other - Middle Name:ANNETTE
Other - Last Name:FAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:10437 MARINE VIEW DR SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98146-1085
Mailing Address - Country:US
Mailing Address - Phone:206-919-5229
Mailing Address - Fax:
Practice Address - Street 1:3500 SW ALASKA ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-2731
Practice Address - Country:US
Practice Address - Phone:206-919-5229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60610565101YM0800X
WAMC60414198101Y00000X, 101YM0800X
WACG60416313101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor