MEDICARE: CLEARPATH OUTPATIENT CLINIC LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1306738182
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEARPATH OUTPATIENT CLINIC LLC

Provider Business Mailing Address
First Line	:	10920 SE 208TH ST STE 5
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98031-4024
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10920 SE 208TH ST STE 5
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98031-4024
Country	:	US
Telephone Number	:	206-566-8317
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	FADUMA MPOHAMED
Credential	:
Telephone Number	:	206-566-8317

Provider Enumeration Date	:	07/16/2025
Last Update Date	:	01/27/2026

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Directions to “CLEARPATH OUTPATIENT CLINIC LLC ” Practice Location

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