Organization
MJ CLAYTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEEANN OUTLETT (BILLING MANAGER)
(360) 637-9263
Entity
Organization
Contact information
Practice address
1006 N H ST, 3RD FLOOR, ABERDEEN, WA 98520-2521
(360) 537-6300
(360) 537-6301
Mailing address
PO BOX 1898, ABERDEEN, WA 98520-0315
(360) 637-9263
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP0001451
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9631003
—
WA
Enumeration date
01/06/2017
Last updated
01/06/2017
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