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NPI Code Detail

MEDICARE: CLOVIECE THOMAS SANDERS III

MEDICARE:   CLOVIECE THOMAS SANDERS III
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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1548111206
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLOVIECE THOMAS SANDERS III
Provider Business Mailing Address
First Line : 9217 25TH AVE SW
Second Line :
City : SEATTLE
State : WA
Zip : 98106-2605
Country : US
Telephone Number : 706-254-1667
Fax Number :
Provider Business Practice Location Address
First Line : 9217 25TH AVE SW
Second Line :
City : SEATTLE
State : WA
Zip : 98106-2605
Country : US
Telephone Number : 706-254-1667
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2026
Last Update Date : 02/06/2026

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Directions to “ CLOVIECE THOMAS SANDERS III ” Practice Location

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