MEDICARE: MARY JOY CLAYTON ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP30001451	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770671570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY JOY CLAYTON ARNP

Provider Business Mailing Address
First Line	:	PO BOX 1898
Second Line	:
City	:	ABERDEEN
State	:	WA
Zip	:	98520-0315
Country	:	US
Telephone Number	:	360-637-9263
Fax Number	:	360-637-8732

Provider Business Practice Location Address
First Line	:	1006 N H ST FL 3
Second Line	:
City	:	ABERDEEN
State	:	WA
Zip	:	98520-2521
Country	:	US
Telephone Number	:	360-537-6300
Fax Number	:	360-537-6301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	12/12/2016

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