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Individual

CLYDE TAMPARONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3920 S ORCAS ST, SEATTLE, WA 98118-2266
(206) 883-2113
Mailing address
3920 S ORCAS ST, SEATTLE, WA 98118-2266
(206) 883-2113

Taxonomy

Speciality
Code
Description
License number
State
163WD1100X
Peritoneal Dialysis Registered Nurse
Primary
RN60155360
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
TAMPACA211JN
WASHINGTON DRIVER LICENSE
WA
Enumeration date
08/13/2018
Last updated
08/13/2018
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