Healthcare Provider Details

I. General information

NPI: 1104169721
Provider Name (Legal Business Name): MARIA P CLAFLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA M PINEDA

II. Dates (important events)

Enumeration Date: 04/02/2013
Last Update Date: 01/29/2021
Certification Date: 01/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 9TH AVE MS:C6-GSUR
SEATTLE WA
98101-2756
US

IV. Provider business mailing address

1100 9TH AVE
SEATTLE WA
98101-2756
US

V. Phone/Fax

Practice location:
  • Phone: 206-625-7188
  • Fax: 206-625-7245
Mailing address:
  • Phone: 206-515-5811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60315856
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number16118
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number16118
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: