Individual
MRS. CYNTHIA ANN CLEMENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
13117 SUNRIDGE WAY E, PUYALLUP, WA 98374-4845
(253) 905-7635
Mailing address
13117 SUNRIDGE WAY E, PUYALLUP, WA 98374-4845
(253) 905-7635
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT00001124
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4697CL
REGENCE BLUE SHIELD
WA
05
—
7682511
—
WA
Enumeration date
01/02/2007
Last updated
07/09/2007
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