Provider Demographics
NPI:1174736607
Name:PATCH, DEBBIE PIAN (OD)
Entity type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:PIAN
Last Name:PATCH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:DEBBIE
Other - Middle Name:M
Other - Last Name:PIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:15941 SE COUGAR MOUNTAIN WAY
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5680
Mailing Address - Country:US
Mailing Address - Phone:714-932-3600
Mailing Address - Fax:425-455-4055
Practice Address - Street 1:2606 116TH AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-1422
Practice Address - Country:US
Practice Address - Phone:425-462-7664
Practice Address - Fax:425-462-6429
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2731152W00000X
MA4790152W00000X
RI563152W00000X
CA11451152W00000X
NY7208152W00000X
WA3697152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist