Provider Demographics
NPI:1225835242
Name:DEBIQUE, PATRECE ANIKA
Entity type:Individual
Prefix:
First Name:PATRECE
Middle Name:ANIKA
Last Name:DEBIQUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15605 157TH AVE SE # NA
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-6343
Mailing Address - Country:US
Mailing Address - Phone:786-339-3959
Mailing Address - Fax:
Practice Address - Street 1:1010 S 336TH ST STE 205
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7354
Practice Address - Country:US
Practice Address - Phone:360-488-8211
Practice Address - Fax:866-230-4506
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP700412179363LP0808X
WA605519719163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine