Provider Demographics
NPI:1548302755
Name:PATRAS, COY
Entity type:Individual
Prefix:
First Name:COY
Middle Name:
Last Name:PATRAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 E OREGON RD
Mailing Address - Street 2:
Mailing Address - City:ELK
Mailing Address - State:WA
Mailing Address - Zip Code:99009-8714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:210 W SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3627
Practice Address - Country:US
Practice Address - Phone:509-747-8224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00031952101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor