Basic Information
Provider Information
NPI: 1467729350
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ATCHISON
FirstName: PATRICIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: HAD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8800 SE SUNNYSIDE RD
Address2: STE 300-N
City: CLACKAMAS
State: OR
PostalCode: 970155738
CountryCode: US
TelephoneNumber: 5036595115
FaxNumber:  
Practice Location
Address1: 2470 PATTERSON RD
Address2: STE 10
City: GRAND JUNCTION
State: CO
PostalCode: 815051279
CountryCode: US
TelephoneNumber: 9702427664
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/21/2011
LastUpdateDate: 11/21/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000X141COY Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


Home