MEDICARE: JAMES T CLEMEN 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	208600000X	Surgery Physician	MD00028427	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861427346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES T CLEMEN MD

Provider Business Mailing Address
First Line	:	11311 BRIDGEPORT WAY SW STE 309
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-3078
Country	:	US
Telephone Number	:	253-985-2733
Fax Number	:	253-985-2868

Provider Business Practice Location Address
First Line	:	11311 BRIDGEPORT WAY SW STE 309
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-3078
Country	:	US
Telephone Number	:	253-985-2733
Fax Number	:	253-985-2868

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	05/30/2024

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Directions to “ JAMES T CLEMEN MD” Practice Location

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