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Individual

KEVIN R CLAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7205 265TH ST NW, STANWOOD, WA 98292-6221
(360) 629-1504
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34133
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1008135
WA
Enumeration date
02/27/2006
Last updated
12/06/2012
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