Individual
DANIEL T CLERC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3021 GRIFFIN AVE, ENUMCLAW, WA 98022-2369
(360) 825-6511
(360) 825-6536
Mailing address
3021 GRIFFIN AVE, ENUMCLAW, WA 98022-2369
(360) 825-6511
(360) 825-6536
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00043068
WA
207QS1201X
Sleep Medicine (Family Medicine) Physician
MD00043068
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0180969
STATE L&I
WA
01
—
0290515
STATE L&I
WA
05
—
8381014
—
WA
Enumeration date
07/30/2006
Last updated
04/03/2012
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