Patrick Michael Gorman, SUDP TRAINEE

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO61366452 Issued in WA

Practice address

2610 Wetmore Ave
Everett, WA 98201-2927

Phone

(425) 258-5270

Fax

(425) 258-5275

NPI assigned

Apr 20, 2023

Sex

Male

Sole proprietor

Yes

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

State licenses

Practice roles

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.

• Catholic Community Services Western Washington

  dba CCS RECOVERY CENTER-Snohomish

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Everett, WA
  • NPI 1669645073
  NPD (past)

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1952098725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 WETMORE AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012927",
            "telephone_number": "425-258-5270",
            "fax_number": "425-258-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 WETMORE AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012927",
            "telephone_number": "425-258-5270",
            "fax_number": "425-258-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "PATRICK",
        "middle_name": "MICHAEL",
        "credential": "SUDP TRAINEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61366452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catia Gordon
• Chelsea Rae Holzinger Gordon, N.D.
• David M. Gordon, MD
• Gavin Gordon, MD
• Katelynn Marie Gordon, PT, DPT
• Divine Grace Gorospe, ARNP
• Tiffany D Gorski, MSW
• Yin-Yin NG Goshert, DPT
• Nicole Goss, LMT
• Gothic Sage Therapy and Design PLLC

• Addiction (Substance Use Disorder) Counselor in Everett, WA
• Providers in Everett, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.