Provider Demographics
NPI:1962179192
Name:CALVO, PATRICK ANDREW (LMFTA)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:ANDREW
Last Name:CALVO
Suffix:
Gender:M
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 E ROSE ST UNIT 204
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-1257
Mailing Address - Country:US
Mailing Address - Phone:425-766-0605
Mailing Address - Fax:
Practice Address - Street 1:345 BOYER AVE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2083
Practice Address - Country:US
Practice Address - Phone:509-527-5195
Practice Address - Fax:509-527-4904
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG6135433106H00000X
WAMG61354333106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist