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Provider Information for 1417920810


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Mr. JUDE FARRELL PATTON PA-C


Sex: Male

NPI: 1417920810
Last Updated: 2007-07-08
Certification Date:

Details

NameValue
NPI1417920810
Enumeration Date2006-02-08
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 3802 BROADWAY
SUITE B
EVERETT, WA 98201-5032
United States

Phone: 425-259-6665 | Fax:360-336-2870
 
Primary Practice Address 3802 BROADWAY
SUITE B
EVERETT, WA 98201-5032
United States

Phone: 425-259-6665 | Fax:360-336-2870
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 363A00000X - Physician Assistant WAPA10003235