Individual
GARY DON CLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
4011 TALBOT RD S, SUITE 500, RENTON, WA 98055-5773
(425) 251-5110
(425) 793-7376
Mailing address
4011 TALBOT RD S, SUITE 500, RENTON, WA 98055-5773
(425) 251-5110
(425) 793-7376
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
PA10002668
WA
207RN0300X
Nephrology Physician
PA506
ID
363AM0700X
Medical Physician Assistant
Primary
PA10002668
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010143887
REGENCE BLUE SHIELD OF ID
—
05
—
805004000
—
ID
05
—
8373383
—
WA
Enumeration date
09/27/2006
Last updated
08/29/2014
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