Clyde, Jon C

Clyde, Jon C is an individual health care provider with primary practice located at 217 W Cataldo Ave , Spokane WA 99201-2217. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Clyde, Jon C can be contacted via phone (509) 747-6194.

Contact Information

Primary practice address
217 W Cataldo Ave Spokane WA 99201-2217
Fax: (509) 838-0824
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD00027478 Washington

Profile Details

NPI number 1891767943
LBN Legal business name Clyde, Jon C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated Sep 8th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891767943 NPPES
Washington Other 305785 LABOR& INDUSTRIES
Washington Other P01152325 LABOR& INDUSTRIES
Washington MEDICAID 1021532 LABOR& INDUSTRIES

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