Provider Demographics
NPI:1548419658
Name:ENDICOTT, PATRICIA LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:ENDICOTT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:LYNN
Other - Last Name:O'KEEFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4800 SAND POINT WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3901
Mailing Address - Country:US
Mailing Address - Phone:206-987-8051
Mailing Address - Fax:206-987-3935
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:MB.11.500.3
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-8051
Practice Address - Fax:206-987-3935
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60054422363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical