Patrick William Black

Primary specialty

Other TechnicianTaxonomy code 247200000X

Practice address

16715 Aurora Ave N Ste 102
Shoreline, WA 98133-5310

Phone

(206) 546-9766

Fax

(206) 542-0326

NPI assigned

Jul 11, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Therapeutic Health Services

  dba Shoreline Branch

  • Methadone Clinic
  • Shoreline, WA
  • NPI 1144312877
  NPD
• Therapeutic Health Services

  • Methadone Clinic
  • Shoreline, WA
  • NPI 1548606171
  NPD (past)

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1861126583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16715 AURORA AVE N STE 102",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335310",
            "telephone_number": "206-546-9766",
            "fax_number": "206-542-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16715 AURORA AVE N STE 102",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335310",
            "telephone_number": "206-546-9766",
            "fax_number": "206-542-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "PATRICK",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Other Technician in Shoreline, WA
• Providers in Shoreline, WA by specialty
• Other Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.