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General NPI Number Information
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NPI Number | 1285850545
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Entity Type | Individual
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Provider Name | RICHARD DEAN CLEMENS D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | ABSOLUTE CHIROPRACTIC 312 GARDNER RD.
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City | BURLINGTON
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State | WA
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Zip | 98233-1531
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Country | US
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Telephone | 360-757-7463
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Fax | 360-757-7171
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Provider Business Mailing Address
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Address Line | 312 GARDNER RD
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City | BURLINGTON
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State | WA
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Zip | 98233-1531
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Country | US
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Telephone | 360-757-6117
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Fax | 360-757-7171
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHOOOO3175
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License Number State | WA
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