Individual
JEREMIAH MALACHI CLINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
212 E CENTRAL AVE STE 440, SPOKANE, WA 99208-6290
(509) 252-1977
(509) 465-3026
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD00047792
WA
207X00000X
Orthopaedic Surgery Physician
ML20007417
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578575734
—
ID
05
—
1578575734
—
MT
05
—
1578575734
—
WA
Enumeration date
08/13/2006
Last updated
10/24/2022
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