Individual provider Active NPI

Antonia Anja Rafaela Patten, MSW

  • Mental Health Counselor
  • Shoreline, WA
National Provider Identifier
1326563057
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
14803 15TH Ave NE
Shoreline, WA 98155-7110
Phone
(206) 631-8805
NPI assigned
Aug 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

14803 15TH Ave NE
Shoreline, WA 98155-7110

Mailing address

17018 15TH Ave NE
Shoreline, WA 98155-5137
Phone (206) 631-8805

Other practice location 1

2204 Pacific Ave N
Long Beach, WA 98631-3300
Phone (360) 642-3787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1326563057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17018 15TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981555137",
            "telephone_number": "206-631-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14803 15TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981557110",
            "telephone_number": "206-631-8805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2204 Pacific Ave N",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "WA",
            "postal_code": "986313300",
            "country_code": "US",
            "telephone_number": "360-642-3787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTEN",
        "first_name": "ANTONIA ANJA",
        "middle_name": "RAFAELA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.