Individual provider · NPI-1

Debra Jean Clinton, PA-C

Physician Assistant, Medical · Medical Lake, WA

NPI number1164647863
StatusActive
Last updated in NPPESJun 17, 2010

Details

NPI
1164647863
Entity type
Individual (NPI-1)
Name
Mrs. Debra Jean Clinton
Credential
PA-C
Sex
Female
Sole proprietor
No
Enumeration date
Apr 16, 2007
Last updated
Jun 17, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AM0700X Physician Assistant, MedicalPA10003293WAYes

Practice location

850 West Maple Street
Medical Lake, WA 99022-0800

Phone 509-565-4000

Mailing address

850 West Maple Street
Medical Lake, WA 99022-0800

Phone 509-565-4000

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