NPI Code Detail JSON Logo

1063307197 NPI number — TRACY ANN CLAYTON CG70010924

NPI Number: 1063307197
Health Care Provider/Practitioner: TRACY ANN CLAYTON CG70010924

Information about “1063307197” NPI (TRACY ANN CLAYTON CG70010924) exists in 1063307197 in HTML format HTML  |  1063307197 in plain Text format TXT  |  1063307197 in PDF (Portable Document Format) PDF  |  1063307197 in an XML format XML  formats.

NPI Number : 1063307197 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1063307197",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CLAYTON",
    "FirstName": "TRACY",
    "MiddleName": "ANN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "CG70010924",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LOCKE",
    "OtherFirstName": "TRACY",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "7440 W MARGINAL WAY S",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SEATTLE",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98108-4141",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "360-757-7738",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "201 LILA LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BURLINGTON",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98233-3320",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "360-757-7738",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/10/2025",
    "LastUpdateDate": "06/10/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YA0400X",
        "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
        "LicenseNumber": "CG70010924",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.