Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP60591631 | WA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP60591631 | WA |
N | 363LP2300X | Nurse Practitioner - Primary Care | AP60591631 | WA |
NPI | 1053722942 |
---|---|
Provider Name | Adam L Clarno |
First Address | Tacoma, WA 98402-3302 |
Second Address | Tacoma, WA 98402-3302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2014 |
Last Update Date | 29/12/2015 |