Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD00031405 | WA |
N | 207VG0400X | Gynecologist | MD00031405 | WA |
NPI | 1396711529 |
---|---|
Provider Name | Jeffrey L. Clemons |
First Address | Tacoma, WA 98405-1702 |
Second Address | Tacoma, WA 98405-1702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 26/11/2013 |