Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LW60536387 | WA |
NPI | 1003186354 |
---|---|
Provider Name | Mr. Patrick Lefebvre Hains |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98122-2499 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2012 |
Last Update Date | 23/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003186354 | (05) | WA |