Healthcare Provider Details

I. General information

NPI: 1679736649
Provider Name (Legal Business Name): CLAYTON JOHN SONTHEIMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE MAIL STOP R-5420
SEATTLE WA
98105
US

IV. Provider business mailing address

4800 SAND POINT WAY NE MAIL STOP R-5420
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 314-974-6773
  • Fax:
Mailing address:
  • Phone: 314-974-6773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number60207732
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number60207732
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: