Individual
DAVID P. CLEMENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12360 LAKE CITY WAY NE, SEATTLE, WA 98125-5447
(206) 384-4382
(206) 440-3137
Mailing address
243 111TH AVE SE, BELLEVUE, WA 98004-6308
(425) 502-8660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD 60137713
WA
207Q00000X
Family Medicine Physician
MD11783
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080085487
RAILROAD MEDICARE
OK
05
—
100110620A
—
OK
01
—
5300256
AETNA EDI
OK
01
—
731297740002
BLUE CROSS BLUE SHIELD
OK
Enumeration date
08/18/2005
Last updated
12/01/2010
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