Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PY60884931 | WA |
N | 103TC0700X | Clinical Psychologist | PY60884931 | WA |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1093965360 |
---|---|
Provider Name | Dr. Kristina Elise Patrick |
First Address | Seattle, WA 98105-3901 |
Second Address | Seattle, WA 98105-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2008 |
Last Update Date | 25/11/2020 |