Nicole Lee Patina, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP60601655 Issued in WA

Practice address

1550 Irving St SW
Tumwater, WA 98512-6358

Phone

(360) 507-8030

NPI assigned

May 4, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: nicole.patina.p1@direct.stillaguamish.nextgenshare.com

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

{
    "created_epoch": "1525392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1992294078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 E MEAD AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989033720",
            "telephone_number": "509-575-8457",
            "fax_number": "509-453-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 IRVING ST SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985126358",
            "telephone_number": "360-507-8030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 S 12th Ave Ste 4B",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989023137",
            "country_code": "US",
            "telephone_number": "509-575-8457 x2932",
            "fax_number": "509-453-1273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATINA",
        "first_name": "NICOLE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-04",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60601655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDP",
            "identifier": "CP60601655",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vandana Pal, OT
• Panza
• Devin Maria Parker
• Hector Angelo Passi, RN
• Mithila Pathare, MSW
• Olena Pavlenko
• Francesca Denise Pearson, M.A.
• Amanda Peluso, AU.D.
• Cecilia Perez, RN
• Rebecca Mae Peters, LMHC

• Addiction (Substance Use Disorder) Counselor in Tumwater, WA
• Providers in Tumwater, 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 Aug 7, 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.