Individual
CLYDE STONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3624 AUBURN WAY N, AUBURN, WA 98002-1801
(253) 508-7571
Mailing address
3624 AUBURN WAY N, AUBURN, WA 98002-1801
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00058014
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP00058014
DOH
WA
05
—
LP00058014
—
WA
Enumeration date
10/26/2018
Last updated
10/26/2018
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