MEDICARE: DAVID A CLINE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD00035363	WA

General Provider Information

NPI Number	:	1205855087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID A CLINE MD

Provider Business Mailing Address
First Line	:	23846 SE KENT KANGLEY RD
Second Line	:
City	:	MAPLE VALLEY
State	:	WA
Zip	:	98038-6848
Country	:	US
Telephone Number	:	253-372-7680
Fax Number	:

Provider Business Practice Location Address
First Line	:	23846 SE KENT KANGLEY RD
Second Line	:
City	:	MAPLE VALLEY
State	:	WA
Zip	:	98038-6848
Country	:	US
Telephone Number	:	253-372-7680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	08/25/2010

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Directions to “ DAVID A CLINE MD” Practice Location

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