Healthcare Provider Details

I. General information

NPI: 1922289032
Provider Name (Legal Business Name): DR JOSEPH PAUL CLABOTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2007
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7424 BRIDGEPORT WAY W STE 307
LAKEWOOD WA
98499-8135
US

IV. Provider business mailing address

PO BOX 11073
TACOMA WA
98411-0073
US

V. Phone/Fax

Practice location:
  • Phone: 253-588-3149
  • Fax: 253-588-2688
Mailing address:
  • Phone: 253-588-3149
  • Fax: 253-588-2688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD00023513
License Number StateWA

VIII. Authorized Official

Name: DR. JOSEPH PAUL CLABOTS
Title or Position: OWNER
Credential: MD
Phone: 253-588-3149