Provider Demographics
NPI:1386176337
Name:GIFFORD, PATRICIA CATHERINE (RN, MHP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:CATHERINE
Last Name:GIFFORD
Suffix:
Gender:F
Credentials:RN, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5451 ALMIRA DR NE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-8330
Mailing Address - Country:US
Mailing Address - Phone:360-377-8583
Mailing Address - Fax:360-415-5887
Practice Address - Street 1:5451 ALMIRA DR NE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-8330
Practice Address - Country:US
Practice Address - Phone:360-377-8583
Practice Address - Fax:360-415-5887
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00166640163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse