Individual
JEFFERY ALAN PATEE COTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
205 8TH ST, HOQUIAM, WA 98550-2507
(360) 764-5762
Mailing address
PO BOX 1164, SOUTH BEND, WA 98586-1164
(564) 888-3000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW30106946
WA
1041C0700X
Clinical Social Worker
LCS 25359
CA
1041C0700X
Clinical Social Worker
LW60106946
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922338896
—
CA
05
—
1922338896
—
WA
05
—
192233896
—
CA
Enumeration date
12/28/2009
Last updated
06/23/2021
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