Provider Demographics
NPI:1942559521
Name:PATTERSON, DENISE M (R PH)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:M
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:R PH
Mailing Address - Street 1:4919 EVERGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203
Mailing Address - Country:US
Mailing Address - Phone:425-259-3444
Mailing Address - Fax:425-339-2212
Practice Address - Street 1:4919 EVERGREEN WAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203
Practice Address - Country:US
Practice Address - Phone:425-259-3444
Practice Address - Fax:425-339-2212
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00011168183500000X
CA36566183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist